We have reviewed the scientific literature related to four diseases in which to serotonin (5-HT) is involved in the etiology, herein named 5-HT-linked diseases, and whose prevalence is influenced by estrogenic status: depression, migraine, irritable bowel syndrome and eating disorders. These diseases all have in common a sex-dimorphic prevalence, with women more frequently affected than men. The co-occurrence between these 5-HT-linked diseases suggests that they have common physiopathological mechanisms. In most 5-HT-linked diseases (except for anorexia nervosa and irritable bowel syndrome), a decrease in the serotonergic tone is observed and estrogens are thought to contribute to the improvement of symptoms by stimulating the serotonergic system. Human pregnancy is characterized by a unique 5-HT and estrogen synthesis by the placenta. Pregnancy-specific disorders, such as hyperemesis gravidarum, gestational diabetes mellitus and pre-eclampsia, are associated with a hyperserotonergic state and decreased estrogen levels. Fetal programming of 5-HT-linked diseases is a complex phenomenon that involves notably fetal-sex differences, which suggest the implication of sex steroids. From a mechanistic point of view, we hypothesize that estrogens regulate the serotonergic system, resulting in a protective effect against 5-HT-linked diseases, but that, in turn, 5-HT affects estrogen synthesis in an attempt to retrieve homeostasis. These two processes (5-HT and estrogen biosynthesis) are crucial for successful pregnancy outcomes, and thus, a disruption of this 5-HT-estrogen relationship may explain pregnancy-specific pathologies or pregnancy complications associated with 5-HT-linked diseases.

我们综述了与5-羟色胺（5-HT）涉及的四种疾病相关的科学文献，以下称为5-HT关联疾病，其患病率受雌激素状态的影响：抑郁症，偏头痛，肠易激综合征和饮食失调。这些疾病的共同点是性别差异，女性患病的几率高于男性。这些5-HT相关疾病之间的共存提示它们具有共同的生理病理机制。在大多数与5-HT相关的疾病中（神经性厌食症和肠易激综合症除外），血清素能级降低，并且雌激素被认为通过刺激血清素能系统来改善症状。人类妊娠的特征是胎盘独特的5-HT和雌激素合成。妊娠特异性疾病，例如妊娠呕吐，妊娠糖尿病和先兆子痫，与高血清素能状态和雌激素水平降低有关。与5-HT相关疾病的胎儿程序设计是一个复杂的现象，其中涉及明显的胎儿性别差异，这暗示着性类固醇的含义。从机理的角度，我们假设雌激素调节血清素能系统，从而导致针对5-HT相关疾病的保护作用，但是5-HT反过来又会影响雌激素的合成，试图恢复体内平衡。这两个过程（5-羟色胺和雌激素的生物合成）对于成功的妊娠结局至关重要，因此，