Chapter 9 280 through assessment of lifetime history, previous reactions to changes in sex hormones, or biological factors. Research found that those with a lifetime history of abuse, or those who reported more minority stress were more likely to report hormone-related mood complaints (Eisenlohr-Moul et al., 2016; Pilver et al., 2011). Swales et al. (2023) found that perimenopausal women who showed stronger associations between sex hormone fluctuations and mood were also more likely to experience benefit from hormone replacement therapy. Other studies found a possible higher risk of sex hormone-associated changes based on corticoid receptor genotype (Hamstra et al., 2015) or changes in serotonergic systems (Frokjaer, 2020), although overall results on these biological mechanisms underlying individual differences are still mixed. There are a number of new studies which have integrated reported previous adverse mood symptoms during sex hormone changes into their research questions and designs: they studied possible risk of recurrent mood complaints based on previous experiences using OCs (Gingnell et al., 2013), experiences in the peripartum period (Larsen et al., 2023; Schiller et al., 2022) or experiences in the menstrual cycle (Sacher et al., 2023). This approach is proving useful to improve clinical predictions in some cases: Hahn et al. (2021) studied differences in the risk of postpartum depression and found that 31.7% of women who reported experiencing PMS developed postpartum depression, whereas only 3.5% of women without PMS developed postpartum depression. The approach of incorporating previous experiences with mood symptoms during sex hormone changes is sometimes also called taking a “lifespan approach”. Although this approach comes with limitations, including a possible recall bias in the case of retrospective reporting, it could directly inform researchers and hormone users about possible overlapping effects of changes in sex hormones during various periods during their lives. This could create possibilities for prevention and early detection of depression and insomnia during sex hormone changes. Therefore, future studies on OCs and GAHT should take into account the lifespan history of hormone-associated mood changes. 4.3. The role of sex in research: lack of accounting for sex is hindering progress in research Within this thesis, the lack of studies that have accounted for sex differences has at times hindered our ability to build upon existing research. Previous
RkJQdWJsaXNoZXIy MTk4NDMw