One of the best parts about practicing medicine with an engaged team is getting to nerd out over new studies.
That’s exactly what happened when my teammate Leslie shared a fascinating review from the FDA Adverse Event Reporting System (FAERS).
Now let me be clear—this isn’t a randomized controlled trial (RCT). It’s a database review, and like all voluntary reporting systems, it comes with limitations.
But if anything, voluntary reports tend to underestimate what’s really happening.
So when you see a sharp signal like this, it’s worth paying attention.
The Study: Psychiatric Meds and PCOS
Published in mid-2025, the study examined FAERS data to assess whether psychiatric medications may contribute to the development of polycystic ovarian syndrome (PCOS).
The answer?
A resounding yes—or at the very least, a serious correlation worth investigating.
The researchers found that:
- 18 medications were flagged in the FAERS system
- The majority were psychiatric drugs, including antidepressants and antipsychotics
- Reported PCOS cases jumped from 14 in 2004 to 193 in 2024
That’s a 1,200% increase in reported cases over two decades.
(Zhang et al., 2025)
Mechanisms: How These Drugs Might Cause PCOS
We already know that antipsychotics and antiepileptics have been shown to impact ovarian function by:
- Elevating androgens
- Causing metabolic dysfunction
- Disrupting GnRH secretion
- Inducing anovulation and irregular cycles
Even glucocorticoids, commonly prescribed for inflammation, have been associated with iatrogenic PCOS—which is no surprise, considering they’re also implicated in drug-induced diabetes.
These disruptions affect the entire hypothalamic-pituitary-gonadal (HPG) axis, and the downstream impact on mood, metabolism, and reproductive health can be profound.
The Paradigm Shift: From Suppression to Restoration
Here’s what I believe:
The future of psychiatry—just like much of medicine—is heading toward a complete paradigm shift.
Why?
Because the conventional pharmacological model focuses on:
- Suppressing symptoms
- Blocking pathways
- Slowing pathological progress
But hormone replacement therapy (HRT) works on an entirely different level.
Hormones don’t just block or suppress.
They instruct.
Hormones tell the body what story it’s living.
They give cells and tissues the information they need to behave properly.
And when you zoom out, this is the real power of HRT:
âś… It re-establishes cellular instructions
âś… It restores homeostasis at a deep, systemic level
✅ It works with the body’s biology—not against it
Why Providers Need to Pay Attention
As a nurse practitioner or prescribing provider, it’s critical to recognize this growing connection between psych medications and hormonal dysfunction.
And even more important?
Understanding that properly prescribed bioidentical HRT may be one of the most powerful tools we have to:
- Support mental health
- Improve metabolic stability
- Restore reproductive function
- Reduce the need for long-term pharmacologic suppression
Of course, we need more RCTs.
But even now, you can begin practicing a more holistic, hormone-centered model of care—especially if you’ve been trained through a course that focuses on both the science and the nuance.
Want to Learn How to Use HRT in Your Clinic?
If you’re a provider ready to learn how to treat PCOS, hormone imbalances, and even mental health disorders through evidence-based HRT protocols, we’ve built the ultimate training platform for you.
The HRTU Master Course gives you:
- ✅ Step-by-step clinical protocols for women’s HRT
- âś… Deep dives into progesterone, estradiol, testosterone, and thyroid
- âś… Tools to restore hormonal balance in complex cases
- âś… A new lens through which to view psychiatric symptoms and treatment options
👉 Click here to enroll in the Master Course
And let’s co-create a better future for our patients—and ourselves.
