Before, During and After Pregnancy
- Experiencing depression and/or anxiety during or after pregnancy is common. 10 to 15% of people who have given birth are affected by perinatal mood disorders like postpartum depression and/or anxiety and about the same percentage of people experience symptoms of a major depressive disorder during their pregnancy.
- In some rare cases, people experience postpartum psychosis, a psychiatric emergency in which symptoms of mania, depression, severe confusion, loss of inhibition, paranoia, hallucinations, or delusions begin suddenly in the first two weeks after childbirth.
- Trying to conceive, navigating infertility and/or being involuntarily childless, and having experienced a pregnancy or infant loss are all important reproductive health issues that can have significant impacts on our mental health and wellbeing.
- Some of us can experience post-weaning depression and anxiety when weaning children from breastfeeding.
- Hormonal fluctuations related to menstruation have significant impacts on people of reproductive age. Premenstrual Dysphoric Disorder (PMDD) affects 3% to 8% of people who menstruate. PMDD symptoms include severe depression, anxiety, and extreme irritability, which can impact a person’s daily life and their relationships with others.
- Polycystic ovary syndrome (PCOS) is a set of symptoms due to elevated androgens in people with female reproductive organs. Signs and symptoms of PCOS include irregular or no menstrual periods, heavy periods, excess body and facial hair, acne, pelvic pain, difficulty getting pregnant, and patches of thick, darker, velvety skin. This common hormonal disorder could look like irregular menstrual periods, experiencing infertility or signs of excess androgen such as worsening hirsutism, acne and male-pattern baldness. PCOS can also lead to severe mental health issues, including anxiety, depression, and eating disorders.
- The end of a person’s reproductive years can bring mental health challenges, including depression during perimenopause (the time when transition to menopause begins). Because of the intense hormone changes during perimenopause, people are more likely to have menopause related depression before they reach actual menopause.
- Depression affects every part of daily life, including sexuality. It can impact a person’s sex drive, which can affect relationships and the ability to nurture intimacy with partners.
- Some anti-depressants can curb libido and cause erectile dysfunction (ED), a decrease in vaginal lubrication, or difficulties achieving orgasm.
HIV, Syphilis and other Sexually Transmitted Infections
- Some mental health conditions can increase the likelihood of getting HIV, and likewise, people with HIV may be impacted by mental health issues such as depression and anxiety, which can result from the diagnosis of HIV and living with a complex and stigmatized illness.
- Navigating stigma and discrimination, HIV disclosure to potential romantic and sexual partners, STBBI testing in sometimes HIV-phobic health care settings, and the risk of HIV criminalization can have significant impacts on mental health and wellbeing.
- HIV can produce psychological impacts due to its effects on the central nervous system.
- The relationship between HIV and mental health is particularly relevant for those of child-bearing age, due to the potential for mental health factors to impact quality of life while living with HIV, obstetric outcomes, and the risk of perinatal (parent-to-child) transmission of HIV.
- In the last decade, there has been a significant rise in syphilis, a sexually transmitted infection caused by a bacterium that attacks the body in three stages. In most cities, gay and bisexual men have been hit hardest by it and as many as half of syphilis cases are among men who are HIV positive. Syphilis can easily be tested and treated if caught early enough. If not treated, syphilis can evolve to neurosyphilis, which can lead to serious health complications, including (but not limited to) blindness, confusion, sudden personality changes, changes in mental stability, dementia, depression, suicidal ideation, etc.
- Beyond HIV and Syphilis, it is important to speak to the potential mental and emotional impact of other sexually transmitted infections. Because of stigma around being diagnosed with an STI or living with one (even when not curable but manageable like herpes) many people have a difficult time (physically and mentally) with their diagnoses and can experience severe stress and depression.
- Some studies suggest a possible association between hormonal contraception and an increased risk of depression. Higher risks are attributed to progesterone-only forms of hormonal contraception, including IUDs. When deciding on your contraception method, it’s important to consider and discuss all the possible side effects (including mental health effects).
Endometriosis is a painful reproductive disorder that affects millions of people worldwide. This medical condition occurs when the lining of the uterus, called the endometrium, grows in other places, such as the fallopian tubes, ovaries or along the pelvis. When that lining breaks down, like the regular lining in the uterus that produces the menstruation, it has nowhere to go. This causes cysts, heavy periods, severe cramps, severe pelvic pain, and even infertility. The pain, which can be debilitating, is due to internal bleeding from the lining being shed inside the body and can also lead to scar tissue formation, blocked fallopian tubes, and bowel problems.
- The pain caused by endometriosis is often linked with symptoms of depression and anxiety. A 2015 study found that people who experience endometriosis related pelvic pain may have an impaired quality of life or be more susceptible to mental illnesses.
- Despite significant symptoms, many people experience long delays in receiving an endometriosis diagnosis, which can further exacerbate the mental health impacts. This is in part due to the unconscious biases that health care providers may unknowingly hold around how pain is experienced across different genders and ethnicities.
Genital Sexual Pain
- Vulvodynia is a chronic syndrome associated with burning, stinging, irritation, or sharp vulvar pain and it affects an estimated 16% of people with vulvas. Pain presentation varies and may be described as spontaneous (without an obvious cause), provoked by stimulation (e.g., intercourse or tampon use), or both. People with vulvodynia report a poorer quality of life and suffering from psychological distress that can manifest as anxiety and depression.
- Vulvodynia can be more common among people who screen positive for depression or Post Traumatic Stress Disorder (PTSD).
- Other forms of chronic genital sexual pain are vaginismus, a painful vaginal spasm occurring during penetration, and dyspareunia (genital pain associated with sexual intercourse). Genital sexual pain can have significant impacts on mental health and wellbeing.
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