Chloe plopped down beside me on the couch, a beaming smile spread across her face. Her eyes bright with excitement. Chloe vibrates; she always has. “I know what I want for my birthday this year!” she exclaims. We are a few weeks out from her big day, her 11th birthday. I can’t recall what we did for her 10th, had a few friends join her for pizza and a movie I think. She’s number three in our family, and has always just gone with the flow. She’s the pleaser in this bunch. “What?!” I ask. “Don’t say no without thinking about it” she says. “I really want to shave my head and donate my hair to one of those groups that make wigs for kids with cancer. I just really don’t care about my hair and think I should give it to someone who really does care and can’t have their own.” My initial thought is she hasn’t thought this idea through, but also I’m clearly impressed with her depth. She …

There is something these times have uniquely in common – postpartum blues, PMS, the hot flashes and insomnia of menopause… They are marked by low levels of the profoundly important hormone estrogen. There is arguably no greater hormonal shift than the sudden drop of estrogen with the delivery of a baby, hence the surprisingly common incidence of postpartum blues. At a time that should be one of the happiest, a large number of new mothers feel depressed. I have understood the physiology behind postpartum blues and depression, but have wondered how estrogen levels affect us (and my teenage patients) on a day-to-day level. What is the mind-body impact of hormonal fluctuations within our monthly cycles? What oral contraceptives make the most sense for patients seeking cycle regularity, acne treatment and/or cessation of painful periods?

First, let’s analyze the impact of estrogen — Estrogen has a weighty impact on brain function – it has…