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The effects of estradiol on mood and behavior in human female adolescents: a systematic review

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Abstract

Mood disorders and health risk behaviors increase in adolescence. Puberty is considered to contribute to these events. However, the precise impact of pubertal hormone changes to the emergence of mood disorders and risk behaviors is relatively unclear. It is important that inappropriate attribution is not made. Our aim was to determine what is known about the effect of endogenous estradiol on human adolescent girls’ mood and behavior. The databases searched were MEDLINE, Embase, PsycINFO, Education Resources Information Center (ERIC), Pre-MEDLINE, Web of Science, and Scopus for all dates to October 2014. For inclusion, contemporaneous hormone and mood or behavioral assessment was required. Data were extracted following a template created by the authors. Fourteen studies met our inclusion criteria. There was some consistency in findings for mood and estradiol levels, with associations between estradiol and depression and emotional tone and risk taking. Results were less consistent for studies assessing other mood and behavioral outcomes. Most studies were cross-sectional in design; assay methodologies used in older studies may lack the precision to detect early pubertal hormone levels.

Conclusion: Three longitudinal and several cross-sectional studies indicate potential associations between estradiol and certain mood or affective states, especially depression and mood variability though there are insufficient data to confirm that the rise in estradiol during puberty is causative. We believe that it is important for health professionals to take care when attributing adolescent psychopathology to puberty hormones, as the current data supporting these assertions are limited.

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Abbreviations

AQ:

Aggression Questionnaire

BESAA:

Body Esteem Scale for Adolescents and Adults

CAPA:

Child and Adolescent Psychiatric Assessment

CBCL:

Child Behavior Checklist

CDI:

Children’s Depression Inventory

CPA:

Children’s Physical Activity Scale

CPI:

California Psychological Inventory

CSI:

Children’s Somatization Inventory

DISC:

Diagnostic Interview Schedule

DSM-IV:

Diagnostic and Statistical Manual of Mental Disorders, 4th edition

ERIC:

Education Resources Information Center

MAACL:

Multiple Affect Adjective Checklist

MASC:

Multidimensional Anxiety Scale for Children

MEBS:

Minnesota Eating Behavior Survey

MTFS:

Monitoring the Future Survey

OSIQ:

Offer Self-Image Questionnaire

PACES:

Physical Activity Enjoyment Scale

PDS:

Pubertal Development Scale

PRISMA:

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

SIQYA:

Self-Image Questionnaire for Young Adolescents

SPP:

Self-Perception Profile for Children

SSAS:

Sensation Seeking and Anxiety States Test

YBP:

Youth Behavior Profile

YSR:

Youth Self-Report

References

  1. Aksglaede L, Sorensen K, Petersen JH, Skakkebaek NE, Juul A (2009) Recent decline in age at breast development: the Copenhagen Puberty Study. Pediatrics 123:e932–e939

    Article  PubMed  Google Scholar 

  2. Angold A, Costello E, Erkanli A, Worthman C (1999) Pubertal changes in hormone levels and depression in girls. Psychol Med 29:1043–1053

    Article  CAS  PubMed  Google Scholar 

  3. Bakker J, Baum MJ (2008) Role for estradiol in female-typical brain and behavioral sexual differentiation. Front Neuroendocrinol 29:1–16

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  4. Bonthuis PJ, Cox KH, Searcy BT, Kumar P, Tobet S, Rissman EF (2010) Of mice and rats: key species variations in the sexual differentiation of brain and behavior. Front Neuroendocrinol 31:341–358

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  5. Bordini B, Rosenfield RL (2011) Normal pubertal development: part II: clinical aspects of puberty. Pediatr Rev Am Acad Pediatr 32:281–292

    Article  Google Scholar 

  6. Brooks-Gunn J, Graber JA, Paikoff RL (1994) Studying links between hormones and negative affect: models and measures. J Res Adolesc 4:469–486

    Article  Google Scholar 

  7. Brooks-Gunn J, Warren MP (1989) Biological and social contributions to negative affect in young adolescent girls. Child Dev 60:40–55

    Article  CAS  PubMed  Google Scholar 

  8. Buchanan CM, Eccles JS, Becker JB (1992) Are adolescents the victims of raging hormones: evidence for activational effects of hormones on moods and behavior at adolescence. Psychol Bull 111:62–107

    Article  CAS  PubMed  Google Scholar 

  9. Cameron JL (2004) Interrelationships between hormones, behavior, and affect during adolescence: complex relationships exist between reproductive hormones, stress-related hormones, and the activity of neural systems that regulate behavioral affect—comments on part III. Ann N Y Acad Sci 1021:134–142

    Article  PubMed  Google Scholar 

  10. Davison KK, Werder JL, Trost SG, Baker BL, Birch LL (2007) Why are early maturing girls less active? Links between pubertal development, psychological well-being, and physical activity among girls at ages 11 and 13. Soc Sci Med 64:2391–2404

    Article  PubMed Central  PubMed  Google Scholar 

  11. Delemarre-van de Waal HA (2002) Regulation of puberty. Best Pract Res Clin Endocrinol Metab 16:1–12

    Article  CAS  PubMed  Google Scholar 

  12. Dorn LD, Dahl RE, Woodward HR, Biro F (2006) Defining the boundaries of early adolescence: a user’s guide to assessing pubertal status and pubertal timing in research with adolescents. Appl Dev Sci 10:30–56

    Article  Google Scholar 

  13. Duke SA, Balzer BWR, Steinbeck KS (2014) Testosterone and its effects on human male adolescent mood and behavior: a systematic review. J Adolesc Health 55:315–322

    Article  PubMed  Google Scholar 

  14. Forbes EE, Dahl RE (2010) Pubertal development and behavior: hormonal activation of social and motivational tendencies. Brain Cogn 72:66–72

    Article  PubMed Central  PubMed  Google Scholar 

  15. Graber J, Brooks-Gunn J, Warren M (2006) Pubertal effects on adjustment in girls: moving from demonstrating effects to identifying pathways. J Youth Adolesc 35:391–401

    Article  Google Scholar 

  16. Higgins JPT, Green S, Cochrane Collaboration (2008) Cochrane handbook for systematic reviews of interventions. Wiley-Blackwell, Chichester

    Book  Google Scholar 

  17. Hill RA, Boon WC (2009) Estrogens, brain, and behavior: lessons from knockout mouse models. Semin Reprod Med 27:218–228

    Article  CAS  PubMed  Google Scholar 

  18. Kaltiala-Heino R, Kosunen E, Rimpela M (2003) Pubertal timing, sexual behaviour and self-reported depression in middle adolescence. J Adolesc 26:531–545

    Article  PubMed  Google Scholar 

  19. Klump KL, Gobrogge KL, Perkins PS, Thorne D, Sisk CL, Breedlove SM (2006) Preliminary evidence that gonadal hormones organize and activate disordered eating. Psychol Med 36:539–546

    Article  PubMed  Google Scholar 

  20. Klump KL, Keel PK, Sisk C, Burt SA (2010) Preliminary evidence that estradiol moderates genetic influences on disordered eating attitudes and behaviors during puberty. Psychol Med 40:1745–1753

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  21. Laredo SA, Villalon Landeros R, Trainor BC (2014) Rapid effects of estrogens on behavior: Environmental modulation and molecular mechanisms. Front Neuroendocrinol 35:447–458

    Article  CAS  PubMed  Google Scholar 

  22. Lenz B, Muller CP, Stoessel C, Sperling W, Biermann T, Hillemacher T, Bleich S, Kornhuber J (2012) Sex hormone activity in alcohol addiction: integrating organizational and activational effects. Prog Neurobiol 96:136–163

    Article  CAS  PubMed  Google Scholar 

  23. Martin CA, Mainous IAG, Curry T, Martin D (1999) Alcohol use in adolescent females: correlates with estradiol and testosterone. Am J Addict 8:9–14

    Article  CAS  PubMed  Google Scholar 

  24. McCarthy MM (2008) Estradiol and the developing brain. Physiol Rev 88:91–124

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  25. Mendle J, Harden KP, Brooks-Gunn J, Graber JA (2010) Development’s tortoise and hare: pubertal timing, pubertal tempo, and depressive symptoms in boys and girls. Dev Psychol 46:1341–1353

    Article  PubMed Central  PubMed  Google Scholar 

  26. Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 339:b2535

    Article  PubMed Central  PubMed  Google Scholar 

  27. Naninck EFG, Lucassen PJ, Bakker J (2011) Sex differences in adolescent depression: do sex hormones determine vulnerability? J Neuroendocrinol 23:383–392

    Article  CAS  PubMed  Google Scholar 

  28. Nottelmann ED, Susman EJ, Inoff-Germain G (1987) Developmental processes in early adolescence: relationships between adolescent adjustment problems and chronologic age, pubertal stage, and puberty-related serum hormone levels. J Pediatr 110:473–480

    Article  CAS  PubMed  Google Scholar 

  29. Nugent BM, Tobet SA, Lara HE, Lucion AB, Wilson ME, Recabarren SE, Paredes AH (2012) Hormonal programming across the lifespan. Horm Metab Res 44:577–586

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  30. O’Dea JA, Abraham S (1999) Onset of disordered eating attitudes and behaviors in early adolescence: interplay of pubertal status, gender, weight, and age. Adolescence 34:671–679

    PubMed  Google Scholar 

  31. Ostlund H, Keller E, Hurd YL (2003) Estrogen receptor gene expression in relation to neuropsychiatric disorders. Ann N Y Acad Sci 1007:54–63

    Article  PubMed  Google Scholar 

  32. Patton GC, Viner R (2007) Pubertal transitions in health. Lancet 369:1130–1139

    Article  PubMed  Google Scholar 

  33. Rapkin AJ, Tsao JCI, Turk N, Anderson M, Zeltzer LK (2006) Relationships among self-rated tanner staging, hormones, and psychosocial factors in healthy female adolescents. J Pediatr Adolesc Gynecol 19:181–187

    Article  PubMed  Google Scholar 

  34. Romans S, Clarkson R, Einstein G, Petrovic M, Stewart D (2012) Mood and the menstrual cycle: a review of prospective data studies. Gend Med 9:361–384

    Article  PubMed  Google Scholar 

  35. Rosner W, Hankinson SE, Sluss PM, Vesper HW, Wierman ME (2013) Challenges to the measurement of estradiol: an endocrine society position statement. J Clin Endocrinol Metab 98:1376–1387

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  36. Sato K, Akaishi T, Matsuki N, Ohno Y, Nakazawa K (2007) beta-Estradiol induces synaptogenesis in the hippocampus by enhancing brain-derived neurotrophic factor release from dentate gyrus granule cells. Brain Res 1150:108–120

    Article  CAS  PubMed  Google Scholar 

  37. Slap GB, Khalid N, Paikoff RL, Brooks-Gunn J, Warren MP (1994) Evolving self-image, pubertal manifestations, and pubertal hormones: preliminary findings in young adolescent girls. J Adolesc Health 15:327–335

    Article  CAS  PubMed  Google Scholar 

  38. Spear LP (2000) The adolescent brain and age-related behavioral manifestations. Neurosci Biobehav Rev 24:417–463

    Article  CAS  PubMed  Google Scholar 

  39. Stattin H, Kerr M, Skoog T (2011) Early pubertal timing and girls’ problem behavior: integrating two hypotheses. J Youth Adolesc 40:1271–1287

    Article  PubMed  Google Scholar 

  40. Steinbeck K, Hazell P, Cumming RG, Skinner SR, Ivers R, Booy R, Fulcher G, Handelsman DJ, Martin AJ, Morgan G, Starling J, Bauman A, Rawsthorne ML, Bennett DL, Chow CM, Lam MK, Kelly P, Brown NJ, Paxton K, Hawke C (2012) The study design and methodology for the ARCHER study—adolescent rural cohort study of hormones, health, education, environments and relationships. BMC Pediatr 12:143

    Article  PubMed Central  PubMed  Google Scholar 

  41. Susman EJ, Dorn LD, Chrousos GP (1991) Negative affect and hormone levels in young adolescents: concurrent and predictive perspectives. J Youth Adolesc 20:167–190

    Article  CAS  PubMed  Google Scholar 

  42. Susman EJ, Granger DA, Murowchick E, Ponirakis A, Worrall BK (1996) Gonadal and adrenal hormones. Developmental transitions and aggressive behavior. Ann N Y Acad Sci 794:18–30

    Article  CAS  PubMed  Google Scholar 

  43. Susman EJ, Inoff-Germain G, Nottelmann ED, Loriaux DL, Cutler GB Jr, Chrousos GP (1987) Hormones, emotional dispositions, and aggressive attributes in young adolescents. Child Dev 58:1114–1134

    Article  CAS  PubMed  Google Scholar 

  44. Susman EJ, Nottelmann ED, Inoff-Germain GE, Dorn LD, Cutler GB Jr, Loriaux DL, Chrousos GP (1985) The relation of relative hormonal levels and physical development and social-emotional behavior in young adolescents. J Youth Adolesc 14:245–264

    Article  CAS  PubMed  Google Scholar 

  45. Vermeersch H, T’Sjoen G, Kaufman J-M, Vincke J (2008) Estradiol, testosterone, differential association and aggressive and non-aggressive risk-taking in adolescent girls. Psychoneuroendocrinology 33:897–908

    Article  CAS  PubMed  Google Scholar 

  46. Vermeersch H, T’Sjoen G, Kaufman JM, Vincke J, Van Houtte M (2010) Gender ideology, same-sex peer group affiliation and the relationship between testosterone and dominance in adolescent boys and girls. J Biosoc Sci 42:463–475

    Article  PubMed  Google Scholar 

  47. Warren MP, Brooks-Gunn J (1989) Mood and behavior at adolescence: evidence for hormonal factors. J Clin Endocrinol Metab 69:77–83

    Article  CAS  PubMed  Google Scholar 

  48. Zaccai JH (2004) How to assess epidemiological studies. Postgrad Med J 80:140–147

    Article  PubMed Central  CAS  PubMed  Google Scholar 

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Acknowledgments

The authors would also like to thank Monica Cooper, Faculty Liaison Librarian, University of Sydney Medical Library, for her assistance in database search optimisation.

Author’s contributions

B.W.R. Balzer developed search strategy, performed literature search, extracted data, drafted the initial manuscript, and revised subsequent drafts.

S-A. Duke developed search strategy and critically reviewed drafts

C.I. Hawke conceptualized study and critically reviewed and revised manuscript

K.S. Steinbeck conceptualized study, developed search strategy, extracted data, and critically reviewed drafts.

All the authors approve the final manuscript as submitted.

Funding source

The ARCHER study is supported by the Australian National Health and Medical Research Council (NHMRC) Project Grant #1003312. The authors acknowledge the Sydney Medical School’s Medical Foundation Grant which supported the initial feasibility studies.

Conflict of interest

None

Author information

Authors and Affiliations

  1. Academic Department of Adolescent Medicine, The Children’s Hospital at Westmead, Westmead, NSW, 2145, Australia

    Ben W. R. Balzer & Katharine S. Steinbeck

  2. Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, NSW, 2006, Australia

    Ben W. R. Balzer & Katharine S. Steinbeck

  3. Department of Endocrinology, Royal North Shore Hospital, St. Leonards, NSW, 2065, Australia

    Sally-Anne Duke

  4. School of Rural Health, Sydney Medical School, The University of Sydney, Orange, NSW, 2800, Australia

    Catherine I. Hawke

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  1. Ben W. R. Balzer
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Correspondence to Katharine S. Steinbeck.

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Communicated by Jaan Toelen

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Balzer, B.W.R., Duke, SA., Hawke, C.I. et al. The effects of estradiol on mood and behavior in human female adolescents: a systematic review. Eur J Pediatr 174, 289–298 (2015). https://doi.org/10.1007/s00431-014-2475-3

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