REPRODUCTIVE FAILURE: MENTAL HEALTH EFFECTS IN WOMEN

Requested is a Research Scientist Development Award, Level I, from ADAMHA to study mental health effects of reproductive failure in women. Broad training is proposed in three general areas -- effects of sex steroids on brain and behavior; the study of clinical manifestations of patients with a variety of endocrinological disorders, including pubertal failure, infertility and estrogen deficiency; and the methodology of interdisciplinary research (design, assessment methods, and data analysis) on behavioral manifestations of women with reproductive disorders. The first of these areas will be covered by working in the Psychoendocrinology Research Unit at the New York State Psychiatric Institute, directd by Drs. Anke A. Ehrhardt and Heino F.L. Meyer-Bahlburg. It will include participation in two studies -- one on long-term mental health effects of prenatal diethylstilbestrol (DES) exposure and one on sexual arousal and steroid hormone levels in homosexual and heterosexual women. The second main area will involve training from a committee of experts on sex hormones, clinical endocrinology, and infertility. The third main area consists of training in research design, measure development, and statistics by experts in methodology. A preliminary research project is described which will focus on mental health effects of delayed puberty, growth retardation and infertility in adult women with Turner syndrome. Information from this study as well as from the training described above will be used in a second research project forcusing on mental health effects of infertility in different groups of women with reproductive failure (including Turner syndrome, testicular feminization, exposure to prenatal diethylstilbestrol, and infertility due to anatomical abnormalities of the reproductive tract). These studies will assess systematically for the first time the mental health effects of specific syndromes of reproductive failure and will help to clarify some specific mechanisms in the etiology of p]sychiatric disorders in women. The results will fill a gap in current clinical knowledge and will make it possible to devise clinical strategies in the prevention and treatment of mental health problems in the health care system for women.