Depression in the menopause transition: risks in the changing hormone milieu as observed in the general population

Abstract

There is accumulating evidence but no definitive answers about the incidence of depressed mood in the menopause transition and its association with the changing hormonal milieu. While a changing hormonal milieu is the natural condition for all women, only a minority of mid-life women experience debilitating depressive symptoms or clinical depression. This review focuses on associations between depressed mood and the menopause transition, primarily as identified in longitudinal, population-based studies in the past decade. Further aims were to present reported associations between depressed mood and reproductive hormones in the menopause transition as evaluated in the general population and associations of depressive symptoms or clinical depression with menopausal hot flashes or poor sleep in perimenopausal women. There is evidence to support the role of the changing endocrine milieu in the development of depressed mood in the menopause transition, but the contribution of hormones as measured is small. Disentangling the numerous factors that are associated with depression in midlife women is a major challenge for research and for clinical care, where treatments are needed to improve the most distressing menopausal symptoms.

Depressed mood during the menopausal transition: is it reproductive aging or is it life?

“…In the analyses presented here, depressed mood severity reported for a 24 h period was not related to any of the MT markers. Although prior research has provided limited evidence linking endocrine changes and the MT stages to depressive symptoms and also to episodes of major depressive disorder among women with no prior history of depression, Freeman’s recent review concluded that the contribution of the changing endocrine milieu to the development of depressive symptoms was small [21]. She reminded us that only a minority of women experience debilitating depressive symptoms during this part of the lifespan and that hormonal change is not the only factor to consider in disentangling the complex pathways to depression.…”

“…There was not a significant relationship between hot flashes and depressed mood over the past 24 h in the diary-based data reported here. In contrast, Freeman’s review [21] indicated that although the association between hot flashes and depressive symptoms predominantly measured with the CES-D was confirmed, the direction of the relationship was unclear and evidence for a relationship between hot flashes and major depressive disorder was much less clear. Although hot flashes predicted negative mood on the next day in SWAN daily diary data, negative mood did not predict hot flashes on the subsequent day [49].…”

“…Given the relationship seen between reproductive aging stages and depressed mood, it is tempting to attribute this association to hormonal changes. Investigations of the relationship of estrogen, testosterone, DHEAS, inhibin B, LH and FSH levels and variability to depressed mood have yielded a lack of definitive conclusions, likely attributable to variability in the endocrine measures, their timing and frequency, variability in the depressed mood measure and various analytic strategies used to assess hormone effects [21]. Nonetheless, there is some evidence implicating some hormones: POAS investigators found evidence for effects of increased levels of estradiol, FSH, decreased levels of inhibin B and LH, and greater estradiol, LH, and FSH variability on depressive symptoms (CES-D) [16, 17].…”

Early termination of menstrual function: modern views on pathogenesis and consequences

“…Попри відомі дані про динаміку гормональних зрушень, механізми, що спричинюють зміни безпосередньо в яєчниках, є недоведеними [2]. Середній вік припинення МФ у світі коливається залежно від рівня економічного розвитку держави в межах 49-52 роки [3].…”

Effects of Camellia Sinensis Extract on Repeated Restraint Stress-Induced Ovariectomized Female Rats

“…Depression is the most common of all the psychiatric disorders, and it is the main clinical manifestation of menopausal depression. In the National Comorbidity Survey, major depression is more ordinary in women than in men until late life, with a lifetime prevalence of 21% compared to 12% for men [1]. It was found that estrogens have intense effect on symptoms of depression [2].…”