87: Dr. Felice Gersh: Sex hormones and their impact on mental health

In this IMMH 2023 conference presentation on "Sex Hormones and their Impact on Mental Health", Dr. Gersh explains why ovarian hormones influence so much more than reproduction – and why they are a missing ingredient in many conversations about brain health, mood disorders and cognitive decline. She highlights the disproportionate burden of depression and anxiety in women and notes that nearly a quarter of women in their 40s and 50s (peri/early menopause) are being prescribed antidepressants, arguing that hormone health must be considered as part of the bigger clinical picture.

Dr. Gersh is a dual board-certified OB-GYN and integrative physician, founder and director of the Integrative Medical Group of Irvine, and a leading voice in women's hormonal and metabolic health. In this session she combines clinical and scientific data and decades of experience to demonstrate that estradiol (E2) plays a central, protective role in the brain, supporting energy production, regulating inflammation and maintaining neurological resilience.

In this very informative and practical talk, Dr. Gersh outlines how hormonal decline and disruption can increase vulnerability to mood disorders, migraines, cognitive symptoms and neurodegeneration – and how optimizing hormones through lifestyle, nutrition and psychological therapies can help protect long-term brain health. The overall message is both preventative and hopeful: many hormone-related mental health risks are modifiable and treatable.

In this episode, you will learn:

• Why sex hormones function as whole-body "life/health hormones," supporting brain, metabolic and immune health – not just reproduction.

• How hormones are a missing piece in many discussions of depression, anxiety and cognitive decline in women.

• That almost 25% of peri- and early-menopausal women are prescribed antidepressants, highlighting the scale of midlife mood symptoms.

• The association between teen oral contraceptive use and higher lifetime cardiovascular events, including heart attacks and strokes.

• How estradiol (E2) is strongly neuroprotective, supporting brain energy metabolism and cellular resilience.

• Why women have approximately 2.5× the incidence of Alzheimer's disease, and how hormone loss may contribute to that risk.

• How estradiol helps regulate microglia, astrocytes and neuroinflammation, keeping the brain's immune response balanced.

• The role of estradiol in maintaining the blood–brain barrier, and how deficiency may increase inflammatory vulnerability.

• Emerging evidence that low-dose estradiol therapy may support mood stability, including in postpartum depression and certain bipolar presentations.

• Why progesterone is also neuroprotective and anti-inflammatory, with important roles in mood, mitochondrial function and overall brain health.