Many reproductive steroids have neuroactive effects that can modulate neuro
nal excitability and influence emotions. Emotional disorders may result whe
n 1) abnormal endocrine states interact with normal brain, 2) normal endocr
ine states interact with abnormal brain, and 3) abnormal endocrine states i
nteract with abnormal brain. An understanding of these pathogenetic relatio
nships and the potential therapeutic role of reproductive hormones should l
ead to a more effective and comprehensive management of women and men with
anxiety and mood disorders.