Psychiatrist’s Guide to Reproductive Psychiatry During Menopause - Part 2

Navigating midlife hormonal changes requires personalized mental health strategies. In this episode, Dr. Polly Watson continues her discussion with Dr. Elizabeth Cox, a board-certified psychiatrist specializing in reproductive psychiatry from UNC Chapel Hill. With over a decade of experience, Dr. Cox highlights the critical impact of hormonal changes on women’s mental health during midlife.

The episode explores the use of antidepressants for perimenopausal women, focusing on the decision-making process for pharmaceutical intervention, especially when anxiety or mood disruptions affect quality of life. Dr. Cox emphasizes tailoring treatments to each patient’s values and lifestyle goals.

Addressing concerns like weight gain and sexual dysfunction, Dr. Cox suggests strategies such as adjusting medication dosages, using supplementary medications like Buspar or Wellbutrin, and exploring topical agents like CBD oil. Open communication between patients and providers is key to managing these side effects.

Dr. Cox also discusses the role of genetic testing in personalizing mental health treatments, particularly for those with multiple unsuccessful medication trials or severe side effects. Her approach in reproductive psychiatry emphasizes caution, minimalism, and collaboration, creating a supportive environment for women during hormonal transitions.

Quotes

• “If consistently you’re feeling like your anxiety or your mood symptoms are in the driver’s seat and that you’re in the back seat, just kind of like along for the ride, that feels problematic.” (03:05 | Dr. Elizabeth Cox)
• “The weight gain typically should be like 5-10 pounds max, more of like water weight. But that being said, everybody’s different. So I’m always open-minded here.” (08:37 | Dr. Elizabeth Cox)
• “What I feel from this conversation with you is this balance, this gentleness, a lot of choice, a lot of partnership, right? And I think so often women are offered antidepressant medication without a lot of this kind of more nuanced conversation and they feel like they’ve been put off and then they’re closing themselves off to something that might actually be helpful, but they have fear around it, they felt shame around it, they felt judgment around it.” (16:24 | Dr. Polly Watson)

Links

Connect with Dr. Elizabeth Cox:

Website: https://www.resetyourhealthandwellness.com/

Instagram: https://www.instagram.com/reset_healthandwellness/

Facebook: Reset Health & Wellness, PLLC

Connect with Dr. Polly Watson:

Website: https://hormonewellnessmd.com/podcast

Resources: https://hormonewellnessmd.com/podcast-resources

New Patient: https://hormonewellnessmdacademy.teachable.com/p/are-we-a-good-fit-new-patient-welcome-course

Instagram: https://instagram.com/hormonewellnessmd

Facebook: https://www.facebook.com/hormonewellnessmd

YouTube: https://www.youtube.com/channel/UCG4Tw8oHGR_6wBZmXrTu9xA

Disclaimer: https://hormonewellnessmd.com/podcast#Disclaimer

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