Understanding the Impact of Menopause on Women With Schizophrenia-Spectrum Disorders: A Comprehensive Review

Abstract

Menopause is a physiological event in women's lives that typically transpires in midlife, denoting the cessation of ovarian function and ultimately leading to the end of reproductive capacity. However, women with schizophrenia-spectrum disorders may encounter unique challenges during this period because of the interaction between hormonal changes and their pre-existing mental health conditions. This literature review aims to investigate the consequences of menopause on women with schizophrenia-spectrum disorders, including modifications in symptomatology, cognitive function, and quality of life. Potential interventions will also be examined, including hormone replacement therapy and psychosocial support. The study findings suggest that menopause can worsen symptoms, such as hallucinations and delusions, and may also impair cognitive function, resulting in memory and executive function difficulties. Nevertheless, hormone replacement therapy and psychosocial support could offer potential avenues to manage symptoms and improve the quality of life for women with schizophrenia-spectrum disorders during menopause.

Long-acting antipsychotic treatments: focus on women with schizophrenia

“…Menopause can have a significant impact on women with SZ-spectrum disorders, leading to changes in symptomatology, cognitive function and quality of life. 91 Oestrogen, via its effect on serotonin, glutamate, noradrenergic and cholinergic pathways, is thought to be relevant to psychosis, 19 and to enhance AP efficacy. 33 Whenever oestrogen levels in women decline, psychotic symptoms increase.…”

“…Adding hormone replacement or selective oestrogen receptor modulators such as raloxifene, including phytoestrogens (bioidenticals) in the diet, and/or providing psychosocial support, instead of raising the AP dose, may prove effective 33 , 91 ; this could be a good strategy for women on LAI-APs, since dose adjustments with these formulations are not so practical. Summary Table 3 outlines the main considerations regarding the use of LAI-APs in pregnancy, postpartum, breastfeeding and menopause.…”

Monitoring the Effectiveness of Treatment in Women with Schizophrenia: New Specialized Cooperative Approaches

“…Women with schizophrenia who are on contraceptive medication, those who show premenstrual symptom exacerbation or are pregnant, those who are postpartum or lactating, and those undergoing menopause all require antipsychotic drug adjustments due to changed hormonal milieu [ 81 , 82 ]. At the time of menopause, the use of long-acting injectable antipsychotics eludes first-pass liver metabolism and, thus, overcomes the effect of estrogen loss on the action of estrogen-dependent liver enzymes, subsequently preventing raised doses and concomitant adverse effects [ 11 ].…”