Here’s What to Know About the First Approved Pill Treatment for Postpartum Depression

Updated on Aug 17, 2023 | Featured, Research, Your Health

On Friday, August 4, 2023, the U.S. Food and Drug Administration (FDA) approved Zurzuvae™ (zuranolone), developed by pharmaceutical firms Biogen and Sage Therapeutics, to treat postpartum depression. The treatment is a pill taken once daily for 14 days, and is the first oral treatment approved for this condition.

“We’re happy there’s attention for a disease that has not gotten much attention thus far,” says Veerle Bergink, MD, PhD, Director of the Women’s Mental Health Program, and Professor of Psychiatry, and Obstetrics, Gynecology and Reproductive Science at the Icahn School of Medicine at Mount Sinai. Zurzavae had received Fast Track and Priority Review designations from the FDA, deemed as having potential to address a serious unmet need.

Veerle Bergink, MD, PhD (left) and Kimberly Mangla, MD (right)

Postpartum depression occurs often enough in mothers, yet the public’s understanding of it remains limited, says Kimberly Mangla, MD, Clinical Director of the Women’s Mental Health Program at Icahn Mount Sinai. “I’m glad we have an additional, possibly effective treatment for patients, and hopefully it will raise conversations and awareness of postpartum depression resources and treatment options,” she adds.

Drs. Bergink and Mangla explain what postpartum depression is, and how Zurzuvae could potentially treat it.

What is postpartum depression?

Postpartum depression can appear similar to other forms of clinical depression, with symptoms that include general low mood, lack of enjoyment, low energy, and low motivation, says Dr. Mangla. But there are unique aspects, such as difficulty bonding with the baby.

Postpartum depression is also different from what is commonly called “baby blues,” which is a common phenomenon of feeling overwhelmed, tearful, or being “hormonal,” notes Dr. Mangla. Baby blues tend to go away after two weeks. “What would be alarming might be feelings of hopelessness, suicidality, or a complete disconnect from the baby that aren’t necessarily a component of baby blues—those are reasons to seek support for what might be postpartum depression,” Dr. Mangla says.

While regulatory or insurance entities might define postpartum depression as occurring within four weeks after delivery, experts in the field—clinicians and researchers—agree that onset can be highly variable, even up to 12 months after delivery, says Dr. Bergink.

“From a psychological or physiological point of view, we know that it could take half a year for a woman’s hormones and immune system to go back to normal,” says Dr. Bergink. “And we have heard women say it could take up to a year before they feel like the person they were before delivery, and psychologically used to the new state of being a mother.”

What is Zurzavae, and how does it work?

Many current antidepressants work by targeting the serotonin system, but this drug works by targeting the gamma-aminobutyric acid receptor GABAA. While there are other drugs in this class of antidepressants, this is the first one approved for postpartum depression, says Dr. Bergink.

How common is postpartum depression?

One in Eight

or about 13 percent of women, have symptoms of depression after birth of baby.

>15 percent

of women in NYC experience depression symptoms after childbirth.

One in Five

women were not asked about depression during a prenatal visit.

>50 percent

of pregnant women with depression were not treated.

Source: Centers for Disease Control and Prevention

However, it is important to note that while this differs from serotonergic antidepressants, there have been no comparative studies done to demonstrate that Zurzavae is any better or worse than other antidepressant treatments out there, she points out. It is also unknown to what extent there is an antidepressant effect beyond the sedative effect, she adds.

What treatment options had been available for postpartum depression?

If the depression is not so severe, options include support therapy, such as cognitive behavioral therapy or psychotherapy, says Dr. Bergink. If it is more severe, then the doctor might consider using antidepressants, such as selective serotonin reuptake inhibitors (SSRIs).

How might Zurzavae differ from other antidepressants?

The way the drug has been marketed is that it works more rapidly than SSRIs, says Dr. Mangla. “Whether or not that’s true, and whether or not that benefit is sustained, we still have no idea,” she says, “but it would be wonderful to have a medication that starts working in three days instead of a few weeks.”

There are still some open questions clinicians might have with Zurzuvae at this point, notes Dr. Bergink. These include its effect on women who are breastfeeding, and whether the drug will keep depression away long beyond the study period, which was 45 days, she says.

What sources of support can mothers experiencing depression seek?

Generally, a mom experiencing depression symptoms should talk to anyone who is in her support system, says Dr. Mangla. This could include friends and family, but also a primary care doctor who might be able to make a referral to a general psychiatrist.

“Because the treatment of depression in postpartum is so similar to treatment of depression outside of postpartum, the disease is often well treated by general practitioners or general psychiatrists,” says Dr. Mangla.

Seeking help from social workers can be useful too. There are many ways mothers can access social workers, including through a local health institution, or even via online resources, such as Postpartum Support International, notes Dr. Mangla.

“Postpartum depression is a very treatable condition,” says Dr. Bergink. “We should do all we can to help mothers feel comfortable about reaching out for support.”

Learn more about women's mental health services and reproductive psychiatry

What has Zurzuvae shown in clinical trials?

Zurzuvae was approved based on data from two randomized, placebo-controlled trials in postpartum depression.

Here are the efficacy and safety highlights:

  • Both studies achieved their primary endpoint: a significant mean reduction from baseline in the Hamilton Rating Scale for Depression (HAMD-17) total score, a 17-item questionnaire on depression symptoms compared to placebo.
  • In one study, Zurzuvae achieved a significant reduction in depressive symptoms as early as day three.
  • Most common side effects of patients on Zurzuvae included drowsiness, dizziness, diarrhea, fatigue, and urinary tract infection.
  • The FDA has included a warning on Zurzuvae’s label that instructs health care providers to advise patients that the drug causes driving impairment due to sedative effects, and patients should not engage in activities that require mental alertness until at least 12 hours after the 14-day treatment.

 

Living with Alopecia Areata: Five Coping Strategies to Help With the Emotional Toll

Updated on Sep 26, 2025 | Your Health

Benjamin Ungar, MD, Director of the Alopecia Center of Excellence at Mount Sinai, examines a patient.

Being diagnosed with alopecia areata, an autoimmune condition that affects millions of people in the United States, brings more than the physical challenges of hair loss. Your emotional state can be greatly influenced by the disease progression.

“The emotional toll of alopecia areata can be devastating, but there are strategies that can help you remain positive, manage your symptoms, and thrive,” says Emma Guttman, MD, PhD, a highly renowned expert in alopecia and other inflammatory skin diseases, and the Waldman Professor of Dermatology and Clinical Immunology, and System Chair of the Kimberly and Eric J. Waldman Department of Dermatology, at the Icahn School of Medicine at Mount Sinai.

For those who may be facing these challenges, Benjamin Ungar, MD, Director of the Alopecia Center of Excellence at Mount Sinai, offers five strategies for coping.

 

Learn about new treatments

Most importantly, keep hope alive by learning about new treatments in the pipeline for alopecia areata. Ask your dermatologist about newly approved and potential future treatments or get involved in clinical trials. Mount Sinai has two clinical trials enrolling adults and several more starting later in 2023 for adults and children with alopecia areata: one with Dupixent (dupilumab), a drug administered by injection, and Sotyktu (deucravacitinib), a pill. Contact your dermatologist or email our Clinical Research Program Director, Giselle Singer at giselle.singer@mssm.edu to see if you qualify for either trial.

 

Reduce and manage stress

Stress is a part of everyday life, and it can affect the cycles of hair loss and regrowth. Many people find that stress can contribute to worsening alopecia. Making healthy living habits a priority can help to relieve stress. Manage your stress with daily exercise, yoga, or daily meditative practice. Get at least seven to eight hours of sleep a night. Turn off notifications on your phone and other electronic devices when you are not working to help you disconnect and recharge. Learn to say no to unnecessary commitments and to create boundaries giving you the space for relaxation and self-care.

 

Be creative with accessories to build confidence

Stylish hats, scarves, or good quality wigs can express your creativity and boost your confidence as well as protect bare skin from the elements. Dealing with hair loss does not preclude looking and feeling your best.

 

Find support.

You are not alone. There are many support groups that can help you connect with other people who are dealing with the same challenges you are facing. These groups can help you manage your feelings, provide a supportive network, and build your self-esteem to help you cope with the challenges ahead.

 

Seek help

Seek help from a professional counselor or therapist. If you are struggling, consider reaching out to a professional who can help treat anxiety or depression by working with you to develop coping strategies specific to your experience.

Learn More About the Alopecia Center of Excellence

How to Keep Your Kids Safe This Summer and All Year Round: Tips From the ER

Aug 8, 2023 | Featured, Your Health

Summer is a time for kids to have fun, enjoy vacations, and especially their favorite outdoor activities. It’s also a time for parents to take notice, as many outdoor injuries and health hazards are preventable.

Chris Strother, MD, and Lauren Zinns, MD, emergency medicine specialists at The Mount Sinai Hospital and associate professors in emergency medicine and pediatrics at the Icahn School of Medicine at Mount Sinai, share five key takeaways to help parents, caregivers, and families recognize and avoid common injuries and health hazards.

Young children are at a high risk of choking

  • Common things they choke on are hot dogs, grapes, and small round toys. Ensure that food is cut into small pieces and that young children are supervised when they are eating.
  • If your child is unable to cough or breathe while choking, call 911 first, then try these maneuvers:
    • For children younger than one year old: Place the infant face down on your arm resting on your thigh. With the palm of your other hand, give the baby five short, yet forceful, blows between the shoulder blades. If that is unsuccessful, place the infant on the back, put two of your fingers in the center of the chest below the nipples and press five times.  Continue five back blows and five chest thrusts until the foreign body is removed. Never place your finger inside the infant’s mouth as that could push the foreign body in further.
    • For children older than one year of age: Stand behind the child with your arms around the child’s waist. Make a fist and place it below the chest just above the navel.  Grab the fist with your other hand and push upward repeatedly until the food particle or toy is removed.

Click here for more information about how to help someone who is choking and for helpful illustrations.

Bug bites and insect stings can cause mild to severe allergic reactions in kids

  • Experts recommend bug spray on all exposed areas of skin, especially in the evenings when flying bugs are out the most, or in wooded areas where ticks are more likely to be found.
  • If your child has a tick, try to remove it as soon as possible.
  • Call your pediatrician if you notice a target-like lesion, as this could represent early signs of Lyme disease.
  • Mosquito bites will often cause a local allergic reaction at the site, this is usually not dangerous. If the area becomes very large, is very painful, or if your child develops a fever, the site might be infected. Call your pediatrician or go to the Pediatric Emergency Department.

Practice safety in the water

The American Academy of Pediatrics (AAP) reports that drowning is the single leading cause of death among children ages 1 to 4. Adult supervision is critical at all times.

  • Always swim with others.
  • Learn to swim at a young age and practice.
  • Wear a life jacket.
  • Be aware of weather conditions.
  • Make sure there is a lifeguard. If you aren’t watching the water, make sure someone else is watching for you, particularly with young children.
  • Here are more tips from the AAP.

Riding bikes and scooting can be great exercise

  • Wear a helmet when riding a bike or scooting. Accidents can happen fast.
  • Keep your bike “tuned up.” Make sure brakes work well and tires are inflated and in good condition.
  • Always obey traffic laws; ride with traffic if riding in the street.
  • Wear bright colors when in the street so cars can see you.

Heat awareness: Make sure to hydrate

  • Hydrate before and after you are in the heat. People don’t often think to drink before they go out, but it makes a huge difference to prevent dehydration.
  • Look for shade if possible, and take frequent breaks from activity to rest.
  • Sunblock is essential. Ensure that children are covered with sunscreen 30 SPF or greater to prevent burns, pain, and skin cancer later in life. Reapply frequently after swimming.
Learn more about Pediatrics at Mount Sinai

What Is Leqembi (lecanemab), and Will It Revolutionize Alzheimer’s Disease Treatment?

Jul 21, 2023 | Featured, Your Health

On July 6, the U.S Food and Drug Administration (FDA) granted traditional approval to Leqembi® (lecanemab), a drug developed by pharmaceutical firms Eisai and Biogen to treat Alzheimer’s disease. This decision converts the accelerated approval Leqembi received in January, following a confirmatory trial that demonstrated verified clinical benefit.

“Up until now, no one considered this a treatable disease,” says Mary Sano, PhD, Professor of Psychiatry and Director of the Alzheimer’s Disease Research Center at the Icahn School of Medicine at Mount Sinai. The full approval of lecanemab marks an exciting chapter for treating Alzheimer’s disease, providing physicians with more options. Cognitive specialists at Mount Sinai are now offering lecanemab as a treatment.

Mary Sano, PhD, Director of the Alzheimer’s Disease Research Center at the Icahn School of Medicine at Mount Sinai

What is lecanemab and how does it tackle Alzheimer’s disease? How might a patient access it at Mount Sinai? Dr. Sano explains why this drug will make a big impact in treating this condition, which is all too common among the aging.

What is lecanemab?

Lecanemab is a monoclonal antibody treatment that’s designed to reduce amyloid beta plaques in the brain. It is delivered as an intravenous infusion, over approximately one hour, once every two weeks.

“It is widely accepted that amyloid beta is a defining agent for Alzheimer’s disease,” says Dr. Sano. While the causes of Alzheimer’s disease are not fully known, accumulations of amyloid beta and other proteins such as tau tangles have been observed in patients, and are hypothesized to cause memory and functional loss.

The drug has been approved for mild cognitive impairment (MCI) and mild dementia. Patients in this category are still able to perform daily tasks, such as driving or going to work, but might experience memory lapses, such as forgetting words or location of objects.

What does this drug mean for patients?

In the confirmatory clinical trial that helped lecanemab clinch its full approval, the drug showed a statistically significant reduction in cognitive decline compared to placebo.

What patients can expect is a slowing of cognitive and functional loss, says Dr. Sano. The outcomes measured in the study relate to instrumental activities that early-stage Alzheimer’s disease patients might struggle with—paying bills, banking, certain computer tasks.

“The demonstrated effect is modest, but it’s robust, seen across all measures,” she notes. Those benefits were seen at month three of treatment and persisted through month 18, at the end of the study.

“I don’t want to overstate that this is the be-all and end-all of treatment,” Dr. Sano adds. “I’m not telling you this is a huge effect and the person goes back to 100 percent normal. But until the lecanemab studies, we had other monoclonal antibodies and we’ve not seen such consistent benefits.”

How can I access lecanemab?

The Centers for Medicare and Medicaid Services (CMS) announced in early July that lecanemab is eligible for Part B coverage under Medicare. One of the requirements is documented evidence of amyloid beta plaque in the brain, which requires imaging.

“If you don’t have the presence of amyloid, this means this is a drug you cannot use, even if you are symptomatic with memory or other cognitive problems,” Dr. Sano says.

Side effects for lecanemab could include amyloid-related imaging abnormalities (ARIA), and take the form of either bleeding or swelling in the brain, or both. Some genetic factors, such as the apolipoprotein E (APOE) ε4 gene, may increase the risk of ARIA. Other factors, such as whether patients are on blood-thinning medications, should also be considered before accessing treatment. At Mount Sinai, each patient who is interested in lecanemab receives a personalized evaluation to determine eligibility and appropriate counseling.

There could be economic barriers to access, Dr. Sano notes. Lecanemab has been reported to cost $26,500 per year. Under traditional Medicare, patients could expect to pay a 20 percent copay for treatment, although that might be covered by a supplemental insurance plan. Eisai has also launched a patient assistance plan.

In addition to the drug, there are other associated costs, including positron emission tomography (PET) for amyloid imaging, infusion, and travel expenses. Coverage of those expenses depends on the insurance.

“We need to make sure underrepresented groups can access this treatment,” says Dr. Sano.

Will lecanemab change how we look at Alzheimer’s disease?

Prior to lecanemab, the prevailing view of patients diagnosed with MCI or mild dementia had been a wait-and-see approach, Dr. Sano says. Practitioners might be resistant to start an early-stage patient on active treatment, and similarly, patients who are highly functional might be reluctant to compromise their autonomy.

“There’s a barrier to changing our culture, but it’s clearly surmountable,” notes Dr. Sano. “The one difference we have to consider is this: people don’t stay in mild dementia forever. We need to change the culture to get this addressed early.”

Online form to request an appointment
Learn more about dementia care at The Barbara and Maurice Deane Center for Wellness and Cognitive Health at Mount Sinai

What has lecanemab shown in clinical trials?

In a placebo-controlled, double-blind randomized study of 1,795 people, lecanemab showed a statistically significant and clinically meaningful reduction in decline of the Clinical Dementia Rating (CDR), a cognitive and functional measure based on patient and caretaker reports and the trial’s primary outcome. Key secondary outcomes included measurements of change in amyloid beta and other cognitive scales and measurements of daily living capabilities.

Here are the efficacy and safety highlights:

  • Lecanemab-treated patients demonstrated a 27 percent slowing of decline in CDR compared to those on placebo at 18 months.
  • Statistical significance for CDR was seen starting as early as six months, with the difference from placebo widening every three months.
  • On a 100-point Centiloids scale, with 0 being a patient with no amyloid beta and 100 being the average amount of plaque a mild-to-moderate Alzheimer’s disease patient might have, the lecanemab group saw reduced plaque burden of 55.5 at 18 months, whereas the placebo group saw an increase of 3.6.
  • Statistical significance for amyloid burden was achieved starting at three months.
  • The most common side effects in the lecanemab group were infusion effects, with 26.4 percent having experienced it. Of those, 96 percent were considered mild to moderate.
  • Other side effects include amyloid-related imaging abnormalities—which could occur from amyloid-targeting therapies—as well as headaches and falls. Serious adverse events were reported in 14 percent of the lecanemab group and 11.3 percent of the placebo group.

Is My Stuffy Nose Congestion or Nasal Polyps?

Updated on Jul 20, 2023 | Ear Nose Throat, Your Health

An occasional stuffy nose due to allergies or infection can be annoying or difficult to manage. But if you are experiencing chronic nasal congestion that is also impacting your sleep and ability to breathe, it may be a sign of something more serious—nasal polyps. However, it is easy to mistake the symptoms of nasal polyps for other conditions, including allergies, a deviated septum, or chronic sinusitis.

Madeleine Schaberg, MD, Director of Rhinology and Skull Base Surgery

In this Q&A, Madeleine Schaberg, MD, Director of Rhinology and Skull Base Surgery at New York Eye and Ear Infirmary of Mount Sinai, defines nasal polyps, the indications you might have them, and why it’s important to seek a diagnosis and treatment quickly.

“There is a lot of overlap between symptoms,” explains Dr. Schaberg, who is also Assistant Professor of Otolaryngology at the Icahn School of Medicine at Mount Sinai. “Furthermore, polyps tend to grow gradually, which means the symptoms can be somewhat insidious until you reach a tipping point. Many people live with nasal polyps for years before receiving a diagnosis.”

What are nasal polyps?
Nasal polyps are benign, inflammation-related growths that occur in the nose and sinuses. One of the most common causes is environmental allergies, but they are also associated with diseases such as aspirin exacerbated respiratory disease and eosinophilic granulomatosis with polyangiitis. In some cases, nasal polyps can also be the result of caustic environmental exposures, such as construction sites or toxins exposures. Although nasal polyps are often soft and painless, they can become swollen or irritated and result in sinus blockages that can have serious impacts on your quality of life.

How do I know if I have nasal polyps?
Two prominent symptoms are associated with nasal polyps: congestion and loss of smell. The degree of congestion is often serious enough that it becomes difficult to breathe through the nose. Human beings are obligate nasal breathers, which means we are much more comfortable breathing through the nose. Polyps create an obstruction, which typically leads to breathing through the mouth, which is very uncomfortable. It can also lead to several issues that can affect your overall health and well-being, such as sleep apnea, frequent sinus infections, and increased frequency of asthma attacks.

How are nasal polyps diagnosed?
If you think the symptoms that you are experiencing are associated with nasal polyps, see an ear, nose and throat (ENT) specialist for a consultation. This will typically involve an examination, a review of your medical history, and a nasal endoscopy. Endoscopy is the best in-office diagnostic tool we have to determine what is going on. It enables us to evaluate all the structures of the nasal cavity in a safe, easy manner without causing discomfort and then proceed based on what we find.

What are my treatment options for nasal polyps?
There are several treatment options depending on the severity of your polyps:

  • For mild cases, a steroid spray is often effective in reducing polyp size and relieving symptoms.
  • For more severe cases, oral steroids may be prescribed.
  • If topical and oral steroid treatments are not effective, and the nasal polyps are extensive, surgical removal may be recommended as a therapeutic approach. This is typically done in an outpatient center through minimally invasive endoscopic surgery.
  • There is also the option of treatment with a biologic medication, such as Dupixent® (dupilumab), which is administered by injection under the skin once every two weeks.

In many cases, patients will receive some combination of these treatments, and then continue treatment with a topical steroid or biologic medication following surgical removal. It is best to think of nasal polyps as a kind of long-term problem, like having high blood pressure. It will be different for every patient, but many require topical steroids, oral steroids, and surgery as an adjunct, along with a biologic medication.

How can I prevent nasal polyps from recurring?
For the most part, maintenance medications, such as topical steroids and biologics, provide the best protection against recurrence. However, nasal polyps are a chronic condition, one that requires regular follow-ups with an ENT specialist to check for signs of regrowth. Furthermore, patients who use topical steroids for maintenance should also be assessed annually by an ophthalmologist for changes in eye pressure related to their medication. As with any condition, early detection and treatment of nasal polyps is ideal. However, a later diagnosis or extreme severity in disease should not ultimately affect the outcomes that you can achieve. The medications, treatments, surgery—everything we offer for polyps—works well at many stages in the course of the disease. The important thing is to see your primary care provider or an ENT specialist if you think you have symptoms.

Learn more about Your Health.

New Study Explores Links Between Women’s Reproductive System and Mental Health Disorders

Updated on Jul 6, 2023 | Featured, Psychiatry, Your Health

Both psychiatric disorders and disorders of the reproductive system are common in women of reproductive age. Often, they co-occur. “There is a lot of overlap between these two disease classes—but very little research into why that is,” says Nina Zaks, MS, Clinical Research Scientist in the Department of Psychiatry at the Icahn School of Medicine at Mount Sinai.

She wanted to learn more about that overlap. Together with Magdalena Janecka, PhD, Assistant Professor, Psychiatry, and Genetics and Genomic Sciences, and other colleagues, she spearheaded a systematic review and meta-analysis to probe the association between mental health and reproductive system disorders in women. Their paper was published in JAMA Network Open in April.

The analysis revealed some interesting patterns—and shone a light on how much more remains to be discovered.

Psychiatric and Reproductive System Disorders: Increased Odds

Nina Zaks, MS

The analysis included 50 qualitative and quantitative studies, each of which explored co-occurring psychiatric diagnoses and reproductive system disorders. The research team cast a wide net, considering a range of psychiatric diagnoses including depression, anxiety, psychosis, and neurodevelopmental disorders such as autism. On the reproductive system side, the team looked into diagnoses such as inflammatory diseases of the female pelvic organs, non-inflammatory disorders of the genital tract, and ovarian dysfunction.

The overlap between the disease classes, they found, is significant. In women with polycystic ovary syndrome (PCOS) and chronic pelvic pain, for instance, the odds of affective disorders were approximately 1.7 to almost four times greater than in women without the disorders. But the team also showed that the overlap between many other psychiatric and reproductive disorders simply has not been studied yet, revealing a considerable gap in knowledge, with potentially serious implications for women’s health.

Overall, the literature shows that women with reproductive system disorders have two to three times the odds of having psychiatric disorders compared to women without those conditions. “We see comorbidity between psychiatric and reproductive disorders everywhere we look,” Dr. Janecka says. “Despite that, there is so much about that comorbidity that has not yet been studied. It’s an urgent research priority to address this.”

Looking for Links in Mental Health and the Reproductive System

What can account for the overlap? Unfortunately, most studies in this area don’t dig into the possible causes, according to the researchers.

Scientists have suggested a number of possible explanations for the association between reproductive system and mental health disorders. For example, stress and quality of life factors associated with mental illness could affect menstrual cycles and reproductive function. Psychiatric medications might interfere with reproductive function. It’s also possible that some underlying genetic causes contribute to both types of disorders.

Though much more research is needed, there are reasons to suspect biological causes for the connection, at least in some cases. “From a mechanism standpoint, it makes sense. Many psychiatric diagnoses present differently between females and males, possibly due to a hormonal component,” Dr. Janecka notes. “Better understanding this connection will provide us with some insight into these mechanisms, while also improving quality of life for patients.”

Polycystic Ovary Syndrome: PCOS and Depression

Magdalena Janecka, PhD

Among the studies that Dr. Janecka’s team analyzed, the largest portion focused on PCOS. Those studies showed that women with PCOS have an increased rate of depression, anxiety disorders, and bipolar disorder.

PCOS is relatively common, affecting as many as 5 to 10 percent of women of reproductive age. The condition is associated with symptoms such as infertility, obesity, acne, and excessive hair growth. One explanation for the increased risk of psychiatric diagnoses in women with PCOS is that those symptoms interfere with quality of life or body satisfaction and self-esteem. However, some emerging evidence suggests that is only part of the story, the researchers found.

The studies suggest that obesity and infertility appear to exacerbate psychiatric symptoms in women with PCOS, but don’t fully explain them. Indeed, genetic factors may play a role in both conditions. In a twin study, for instance, researchers found that the risk of depression was higher not only in people with PCOS, but also in the twin who did not have the syndrome. That implies a possible genetic cause that might increase the risk of both conditions.

 Chronic Pelvic Pain

Another subset of the research the team examined focused on chronic pelvic pain. The condition affects one in seven women in the United States. In some cases, the pain can be traced to problems such as endometriosis. But for many women, the cause of their chronic pelvic pain remains elusive.

Unsurprisingly, chronic pelvic pain is associated with significantly higher rates of depression, the researchers found. Physical pain may not be the only explanation, however. “A number of studies showed that women who had chronic pelvic pain had an increased rate of childhood sexual trauma,” Ms. Zaks says. “This might point toward an environmental explanation for the increased rate of psychiatric diagnoses.”

 Psychiatric Research at Mount Sinai and Beyond

Learning more about the shared mechanisms might help researchers better understand the development of both psychiatric and reproductive system disorders and could point to new directions for treatment.

The findings also suggest that physicians should do more to screen for and treat co-occurring disorders. “It may be that if you address a patient’s reproductive problems, psychiatric treatments may be more successful,” Dr. Janecka says.

The two researchers plan to continue exploring some of these associations in greater detail, but they hope they won’t be the only ones to dig deeper. “We know this association exists, and we know there’s a gap in the research. The data are there, just waiting to be studied,” Ms. Zaks says.

“One of the main things that struck us is how little is known,” Dr. Janecka adds. “This is just the starting point.”

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