Depression in Peri- and Postmenopausal Women: Prevalence, Pathophysiology and Pharmacological Management

Epidemiologic and clinic data have unequivocally supported the notion that women experience more psychiatric problems at some point in their lives compared with men, particularly mood and anxiety symptoms and sleep problems. It is also known that, for some women, such increased risk might be associa...

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Published inDrugs & aging Vol. 30; no. 9; pp. 677 - 685
Main Author Soares, Claudio N.
Format Journal Article
LanguageEnglish
Published Cham Springer International Publishing 01.09.2013
Adis International
Springer Nature B.V
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Abstract Epidemiologic and clinic data have unequivocally supported the notion that women experience more psychiatric problems at some point in their lives compared with men, particularly mood and anxiety symptoms and sleep problems. It is also known that, for some women, such increased risk might be associated with reproductive cycle events such as the postpartum period or the menopausal transition. These periods are not only marked by substantial hormone variations but also quite often accompanied by stressful events and changes in personal, family and professional responsibilities. The complexity of these reproductive-related ‘windows of vulnerability’ poses a challenge to physicians and other professionals dedicated to women’s health across the lifespan. The menopausal transition and early postmenopausal years constitute a characteristic example; during this period in life, dynamic changes in sex hormones and reproductive function co-occur with modifications in metabolism, sexuality, lifestyle behaviours and overall health, sometimes affecting a woman’s quality of life and overall functioning. For most women, however, this transition has little or no significant impact on their mental wellness. A prior depressive episode—particularly if related to reproductive events—is the strongest predictor of mood symptoms or depression during menopausal years. Also, the presence and severity of vasomotor symptoms and other health-related issues appear to modulate the risk for depression in midlife women. Mechanistically, estrogen plays an important modulatory role in mood and cognitive regulation, hence the effects noted when midlife women are exposed to significant estrogen fluctuations or to estrogen-based therapies (use or withdrawal). Transdermal estradiol, as well as serotonergic and noradrenergic antidepressants, have shown efficacy in the management of depression in this population. Other evidence-based treatment options (hormonal, pharmacological, behavioural) are available to clinicians and health professionals who care for this population.
AbstractList Epidemiologic and clinic data have unequivocally supported the notion that women experience more psychiatric problems at some point in their lives compared with men, particularly mood and anxiety symptoms and sleep problems. It is also known that, for some women, such increased risk might be associated with reproductive cycle events such as the postpartum period or the menopausal transition. These periods are not only marked by substantial hormone variations but also quite often accompanied by stressful events and changes in personal, family and professional responsibilities. The complexity of these reproductive-related 'windows of vulnerability' poses a challenge to physicians and other professionals dedicated to women's health across the lifespan. The menopausal transition and early postmenopausal years constitute a characteristic example; during this period in life, dynamic changes in sex hormones and reproductive function co-occur with modifications in metabolism, sexuality, lifestyle behaviours and overall health, sometimes affecting a woman's quality of life and overall functioning. For most women, however, this transition has little or no significant impact on their mental wellness. A prior depressive episode--particularly if related to reproductive events--is the strongest predictor of mood symptoms or depression during menopausal years. Also, the presence and severity of vasomotor symptoms and other health-related issues appear to modulate the risk for depression in midlife women. Mechanistically, estrogen plays an important modulatory role in mood and cognitive regulation, hence the effects noted when midlife women are exposed to significant estrogen fluctuations or to estrogen-based therapies (use or withdrawal). Transdermal estradiol, as well as serotonergic and noradrenergic antidepressants, have shown efficacy in the management of depression in this population. Other evidence-based treatment options (hormonal, pharmacological, behavioural) are available to clinicians and health professionals who care for this population.
Author Soares, Claudio N.
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  organization: Women’s Health Concerns Clinic, St. Joseph’s Healthcare Hamilton, Department of Psychiatry and Behavioural Neurosciences, McMaster University
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Issue 9
Keywords Zolpidem
Sleep Problem
Duloxetine
Escitalopram
Major Depressive Disorder
Mood disorder
Human
Prevalence
Pathophysiology
Menopause
Pharmacotherapy
Depression
Review
Epidemiology
Treatment
Postmenopause
Adult
Female
Woman
Elderly
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Snippet Epidemiologic and clinic data have unequivocally supported the notion that women experience more psychiatric problems at some point in their lives compared...
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SubjectTerms Adult and adolescent clinical studies
Affect - drug effects
Biological and medical sciences
Depression
Depression - drug therapy
Depression - epidemiology
Depression - metabolism
Depression - physiopathology
Emotions
Estrogens
Estrogens - metabolism
Female
Geriatrics/Gerontology
Hormones
Hot flash
Humans
Hypotheses
Internal Medicine
Medical sciences
Medicine
Medicine & Public Health
Menopause
Mental depression
Middle age
Mood disorders
Ovaries
Perimenopause - psychology
Pharmacology. Drug treatments
Pharmacology/Toxicology
Pharmacotherapy
PMS
Postmenopause - psychology
Premenstrual syndrome
Prevalence
Professionals
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Therapy in Practice
Womens health
Title Depression in Peri- and Postmenopausal Women: Prevalence, Pathophysiology and Pharmacological Management
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https://www.ncbi.nlm.nih.gov/pubmed/23801148
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https://search.proquest.com/docview/1428272722
Volume 30
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