Reproductive Psychiatry
Expert psychiatric care for the mental health conditions tied to your hormones, your cycle, and every stage of your reproductive life.
What is reproductive psychiatry?
Where hormones and mental health meet
Reproductive psychiatry is a subspecialty focused on how hormonal changes across your lifespan — from puberty through menopause — shape your brain chemistry and emotional well-being.
Your hormones don't just affect your body. They influence mood, anxiety, sleep, focus, and how you respond to stress. Reproductive psychiatrists understand this biology deeply — and can offer care that a general practitioner or therapist isn't trained to provide.
At Estela Mental Health, reproductive psychiatry is at the center of what we do. Whether you're navigating pregnancy, struggling with a hormonal mood disorder, or going through perimenopause, we offer psychiatric evaluation and medication management grounded in the latest evidence.
Conditions we treat
What we help with
Reproductive psychiatry spans the full arc of reproductive life. We treat:
PMDD & Perimenopause
You're not imagining it.
PMDD is one of the most underdiagnosed conditions in women's mental health — and perimenopause is close behind. Both involve real, measurable hormonal changes that directly affect brain chemistry. Both are frequently missed or mislabeled as "just anxiety" or "getting older."
PMDD causes severe mood symptoms — rage, despair, panic — that follow a predictable pattern each cycle. It's distinct from PMS and responds to specific psychiatric treatments. You deserve a provider who knows the difference.
Perimenopause can begin years before your last period. Mood swings, new-onset anxiety, brain fog, and disrupted sleep are all common — and often hormonal. We evaluate both psychiatric and hormonal factors, and we collaborate with your gynecologist or PCP to coordinate care.
Learn more: Women's Mental Health & HRT
Medication during pregnancy
Psychiatric care doesn't pause for pregnancy
One of the most complex decisions in reproductive psychiatry is whether to continue, adjust, or stop psychiatric medication during pregnancy or while breastfeeding. There is no single right answer — it depends on your diagnosis, your history, and the specific medication.
We help you think through those decisions clearly, weighing the risks of untreated illness against the risks of medication exposure. We also adjust dosing as your physiology changes across trimesters and postpartum.
We work closely with OBs, midwives, and fertility specialists to make sure your care is coordinated — not siloed. You shouldn't have to be the one connecting the dots between your providers.
See also: Perinatal Mental Health · Postpartum & Maternal Mental Health
What to expect
Your first visit
A thorough intake. We take time to understand your full history — psychiatric, medical, hormonal, and reproductive. A 30-minute rushed visit won't cut it here.
A collaborative diagnosis. We explain what we're seeing and why. If we think PMDD, perimenopause, or a perinatal condition is in play, we'll tell you — and show our reasoning.
A treatment plan that fits your life. That might mean medication, therapy referrals, lifestyle changes, or coordination with your OB or endocrinologist. Often a combination.
Ongoing support. Reproductive psychiatry is rarely a one-and-done. We offer follow-up care and adjust your plan as your hormones — and your life — change.
External resources
Trusted support beyond our clinic
Postpartum Support International (PSI) — connects individuals with perinatal-trained mental health professionals and peer support networks. Highly recommended for anyone navigating pregnancy or postpartum mental health.
The Menopause Society — patient education and evidence-based resources on perimenopause and menopause, including symptom management and finding a certified menopause practitioner.
Ready to get the right care?
Estela Mental Health accepts Aetna, Blue Cross Blue Shield, Cigna/Evernorth, Optum, and United Healthcare. Available in-person in Austin and via telehealth across Texas.
Book an appointment