1
|
Jia Y, Zhou Z, Xiang F, Hu W, Cao X. Global prevalence of depression in menopausal women: A systematic review and meta-analysis. J Affect Disord 2024; 358:474-482. [PMID: 38735578 DOI: 10.1016/j.jad.2024.05.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 05/07/2024] [Accepted: 05/09/2024] [Indexed: 05/14/2024]
Abstract
BACKGROUND An association between the menopause and depression is widely reported. This review aims to determine the global prevalence of depression in menopausal women (this includes women in perimenopause and postmenopause). METHODS PubMed, Web of Science, Embase, and PsycINFO databases were systematically searched from database inception until March 1, 2024. Studies with validated methods for assessing the prevalence of depression in perimenopausal and postmenopausal women were included. Two authors independently extracted relevant data. Random effects meta-analysis and Meta-regression analysis were performed using Stata software. RESULTS Total of 55 studies (76,817 participants) were included in the review. A random effects model was used to calculate pooled prevalence. The pooled depression prevalence in menopausal women was 35.6 % (95 % CI: 32.0-39.2 %), with 33.9 % (95 % CI: 27.8-40.0 %) in perimenopausal women, and 34.9 % (95 % CI: 30.7-39.1 %) in postmenopausal women. Subgroup analyses indicated that region, screening tool, study design, and setting moderated the prevalence of depression. Meta-regression indicated that smaller sample sizes and poorer study quality were significantly associated with a higher prevalence. LIMITATIONS There was a high degree of heterogeneity across the included studies. Only articles published in English were included. There was significant publication bias in this meta-analysis. There is insufficient information about many risk factors of menopausal depression in current meta-analysis. CONCLUSIONS Depression is common among menopausal women worldwide. To reduce the negative impact of depression on health outcomes in menopausal women, regular screening and the availability of effective prevention and treatment measures should be made available for this population.
Collapse
Affiliation(s)
- Yu Jia
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Sichuan, China
| | - Zitong Zhou
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Sichuan, China
| | - Feng Xiang
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Sichuan, China
| | - Wanqin Hu
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Sichuan, China
| | - Xuehua Cao
- Department of Gynecology Nursing, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Sichuan, China.
| |
Collapse
|
2
|
Mueller SC, De Franceschi M, Brzozowska J, Herman AM, Ninghetto M, Burnat K, Grymowicz M, Marchewka A. An influence of menopausal symptoms on mental health, emotion perception, and quality of life: a multi-faceted approach. Qual Life Res 2024; 33:1925-1935. [PMID: 38700754 DOI: 10.1007/s11136-024-03641-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2024] [Indexed: 06/14/2024]
Abstract
PURPOSE The menopausal transition brings with it many physical, cognitive, and affective changes in a woman's life, impacting quality of life. Whereas prior work has examined impact on general mental health and cognitive function, research on basic affective processing during menopause remains scarce. METHODS Using a median-split procedure, this pre-registered study examined the impact of stronger (N = 46 women) vs. milder (N = 47 women) menopausal symptoms using a behavioural task of subjective emotion perception (embody) and a passive eye tracking viewing task of emotional faces in addition to self-report questionnaires. After 3 months, participants completed the questionnaires again to examine whether objective measures of emotion perception (eye tracking) might predict mental health at follow-up. RESULTS As anticipated, women with stronger vs. milder menopausal symptoms reported increased symptoms of anxiety, depression, stress, emotion regulation difficulties, and lower quality of life during both time points. While no evidence was found in the behavioural task, eye tracking data indicated blunted emotion perception in women with high menopausal symptoms, while women with low symptoms spent more time looking at happy faces relative to fearful or surprised faces. Although eye tracking or hormonal data did not predict mental health at follow-up, a higher estradiol/FSH ratio indicated a higher quality of life. CONCLUSIONS This study documented an impact of the menopausal transition and strength of menopausal symptoms in particular on objective emotion perception as well as mental health and quality of life in women suffering from stronger vs. milder menopausal symptoms. Clinical implications are discussed.
Collapse
Affiliation(s)
- Sven C Mueller
- Laboratory of Brain Imaging Research, Nencki Institute, Warsaw, Poland.
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium.
| | | | - Julia Brzozowska
- Laboratory of Brain Imaging Research, Nencki Institute, Warsaw, Poland
| | | | - Marco Ninghetto
- Laboratory of Brain Imaging Research, Nencki Institute, Warsaw, Poland
| | - Kalina Burnat
- Laboratory of Brain Imaging Research, Nencki Institute, Warsaw, Poland
| | - Monika Grymowicz
- Department of Gynaecological Endocrinology, Medical University of Warsaw, Warsaw, Poland
| | - Artur Marchewka
- Laboratory of Brain Imaging Research, Nencki Institute, Warsaw, Poland
| |
Collapse
|
3
|
Lewis Johnson T, Rowland LM, Ashraf MS, Clark CT, Dotson VM, Livinski AA, Simon M. Key Findings from Mental Health Research During the Menopause Transition for Racially and Ethnically Minoritized Women Living in the United States: A Scoping Review. J Womens Health (Larchmt) 2024; 33:113-131. [PMID: 38079223 PMCID: PMC10880275 DOI: 10.1089/jwh.2023.0276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2024] Open
Abstract
Background: Racially and ethnically minoritized (REM) women experience social and structural factors that may affect their response to mental health treatment and menopausal symptoms during the menopause transition (MT). This scoping review on mental health during the MT for REM women in the United States was conducted to characterize factors associated with mental health challenges. Materials and Methods: Five databases were searched. Articles were included if focused on MT in REM women in the United States and its territories with specific mental illnesses and published in English from 2005 to 2021. Titles and abstracts and full text were screened. Screening and data collection were completed in duplicate by two reviewers in Covidence. Results: Sixty-five articles were included and indicate that REM women experience a disproportionate burden of depressive symptoms during the MT. Less evidence is reported about anxiety, Post-Traumatic Stress Disorder, psychosis, schizophrenia, and other mental illnesses. The risk factors associated with mental illness during MT are social, structural, and biological. Treatment response to therapeutic interventions is often underpowered to explain REM differences. Conclusion: Depression during the MT is associated with negative outcomes that may impact REM women differentially. Incorporating theoretical frameworks (e.g., intersectionality, weathering) into mental health research will reduce the likelihood that scientists mislabel race as the cause of these inequities, when racism and intersecting systems of oppression are the root causes of differential expression of mental illness among REM women during the MT. There is a need for interdisciplinary research to advance the mental health of REM women.
Collapse
Affiliation(s)
- Tamara Lewis Johnson
- Women's Mental Health Research Program, Office of Disparities Research and Workforce Diversity, National Institute of Mental Health, NIH, Rockville, Maryland, USA
| | - Laura M. Rowland
- Neuroscience of Mental Disorders and Aging Program, Division of Translational Research, National Institute of Mental Health, NIH, Rockville, Maryland, USA
| | - Mahela S. Ashraf
- Department of Psychiatry, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Crystal T. Clark
- Department of Psychiatry, Women's College Hospital, University of Toronto, Toronto, Canada
| | - Vonetta M. Dotson
- Department of Psychology and Gerontology Institute, Georgia State University, Atlanta, Georgia, USA
| | - Alicia A. Livinski
- National Institutes of Health Library, Office of Research Services, Office of the Director, National Institutes of Health, Bethesda, Maryland, USA
| | - Melissa Simon
- Department of Obstetrics and Gynecology, Institute for Public Health, and Medicine (IPHAM)—Center for Health Equity Transformation, Northwestern University, Chicago, Illinois, USA
| |
Collapse
|
4
|
Swales DA, Lozza-Fiacco S, Andersen EH, Cooper JA, Treadway MT, Xia K, Schiller CE, Girdler SS, Dichter GS. Hormone sensitivity predicts the beneficial effects of transdermal estradiol on reward-seeking behaviors in perimenopausal women: A randomized controlled trial. Psychoneuroendocrinology 2023; 156:106339. [PMID: 37540905 PMCID: PMC10568486 DOI: 10.1016/j.psyneuen.2023.106339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 07/18/2023] [Accepted: 07/18/2023] [Indexed: 08/06/2023]
Abstract
Depression is highly prevalent during the menopause transition (perimenopause), and often presents with anxious and anhedonic features. This increased vulnerability for mood symptoms is likely driven in part by the dramatic hormonal changes that are characteristic of the menopause transition, as prior research has linked fluctuations in estradiol (E2) to emergence of depressed mood in at risk perimenopausal women. Transdermal estradiol (TE2) has been shown to reduce the severity of depression in clinically symptomatic women, particularly in those with recent stressful life events. This research extends prior work by examining the relation between E2 and reward seeking behaviors, a precise behavioral indicator of depression. Specifically, the current study utilizes a randomized, double blind, placebo-controlled design to investigate whether mood sensitivity to E2 flux ("hormone sensitivity") predicts the beneficial effects of TE2 interventions on reward seeking behaviors in perimenopausal women, and whether recent stressful life events moderate any observed associations. METHOD Participants were 66 women who met standardized criteria for being early or late perimenopausal based on bleeding patterns. Participants were recruited from a community sample; therefore, mood symptoms varied across the continuum and the majority of participants did not meet diagnostic criteria for a depressive or anxiety disorder at the time of enrollment. Hormone sensitivity was quantified over an 8-week baseline period, using within-subjects correlations between repeated weekly measures of E2 serum concentrations and weekly anxiety (State Trait Anxiety Inventory) and anhedonia ratings (Snaith-Hamilton Pleasure Scale). Women were then randomized to receive 8 weeks of TE2 (0.1 mg) or transdermal placebo, and reward-seeking behaviors were assessed using the Effort-Expenditure for Rewards Task (EEfRT). RESULTS Participants who were randomized to receive transdermal estradiol and who demonstrated greater anxiety sensitivity to E2 fluctuations at baseline, demonstrated more reward seeking behaviors on the EEfRT task. Notably, the strength of the association between E2-anxiety sensitivity and post-randomization EEfRT for TE2 participants increased when women experienced more recent stressful life events and rated those events as more stressful. E2-anhedonia sensitivity was not associated with reward-seeking behaviors. CONCLUSION Perimenopausal women who are more sensitive to E2 fluctuations and experienced more recent life stress may experience a greater benefit of TE2 as evidenced by an increase in reward seeking behaviors.
Collapse
Affiliation(s)
- Danielle A Swales
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Serena Lozza-Fiacco
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Psychology, University of Zurich, Zurich, Switzerland
| | | | - Jessica A Cooper
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | | | - Kai Xia
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Crystal Edler Schiller
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Susan S Girdler
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Gabriel S Dichter
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| |
Collapse
|
5
|
Prevalence and risk factors for depressive and anxiety symptoms in middle-aged Chinese women: a community-based cross-sectional study. BMC Womens Health 2022; 22:319. [PMID: 35906641 PMCID: PMC9338469 DOI: 10.1186/s12905-022-01908-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 07/25/2022] [Indexed: 11/29/2022] Open
Abstract
Background Depression and anxiety have become main public health concerns globally. However, risk factors for depression and anxiety remain unclear. This study was to examine the prevalence and risk factors of depressive and anxiety symptoms in middle-aged Chinese women. Methods This cross-sectional study, conducted in 2018, included 7,727 women aged 40–60 years from the eastern, central and western regions of China. Depressive and anxiety symptoms were determined by the Patient Health Questionnaire-9 and the Generalized Anxiety Disorders-7, respectively. Logistic regression models were used to estimate odds ratios (ORs) for depressive and anxiety symptoms in relation to sociodemographic, lifestyle and menopausal factors. Results Among all participants, 19.5% (1 422/7 275) and 14.2% (1 035/7 275) of participants experienced depressive and anxiety symptoms, respectively. The multivariable logistic regression models showed that age, household income, regular physical activity, chronic diseases, menopausal status, vasomotor symptoms, somatic symptoms and urogenital symptoms were associated with depressive symptoms, while place of residence, regular physical activity, chronic diseases, vasomotor, somatic and urogenital symptoms were associated with anxiety symptoms. Conclusion Depressive and anxiety symptoms were common among middle-aged Chinese women, and certain sociodemographic, lifestyle and menopausal symptoms have an important impact on the risk of depressive and anxiety symptoms.
Collapse
|
6
|
Li D, Zheng H, Tong Y, Li Y. Associations of dietary Provitamin A carotenoid intake with depressive symptoms in midlife women: Results from the study of Women's Health Across the Nation. J Affect Disord 2022; 317:91-97. [PMID: 36030997 DOI: 10.1016/j.jad.2022.08.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 05/14/2022] [Accepted: 08/21/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND To study the association of Provitamin A (pro-A) carotenoid intake from diet with depressive symptoms in midlife women. METHODS Data for this cross-sectional study were retrieved from baseline assessment of the Study of Women's Health Across the Nation (SWAN). Logistic regression and restricted cubic spline models were performed to examine the association pro-A carotenoid intake with depressive symptoms. RESULTS A total of 3054 midlife women aged 42-52 years were included in the present study. In overall midlife women, pro-A carotenoid intake was inversely associated with depressive symptoms (CES-D score ≥16). In premenopausal women, pro-A carotenoid intake was inversely associated with depressive symptoms after adjustment for age, race/ethnicity, total family income, education, physical activity, BMI, use of antidepressant, dietary total caloric, protein, carbohydrate, fat, vitamin C, vitamin E and pro-A carotenes in model 1. In fully adjusted model, after additional adjustment for day of cycle, FSH and SHBG, this association remained statistically significant. The fully adjusted odds ratios (ORs) with 95 % CI of depressive symptoms were 0.685 (0.450-1.043) in quartile 4 compared with quartile 1 for pro-A carotenoid intake. However, in early perimenopausal women, no statistically significant difference was observed between pro-A carotenoid intake and depressive symptoms after adjustment for confounders. LIMITATIONS This was a cross-sectional study, limiting causal inferences. Assessment of CES-D was based on a self-report scale. CONCLUSION Pro-A carotenoid intake may be inversely associated with depression symptoms in premenopausal women, but not in early perimenopausal women.
Collapse
Affiliation(s)
- Di Li
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Hongyun Zheng
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Yongqing Tong
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Yan Li
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan 430060, China.
| |
Collapse
|
7
|
Psychological and social health outcomes of physical activity around menopause: A scoping review of research. Maturitas 2022; 164:88-97. [DOI: 10.1016/j.maturitas.2022.07.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 06/30/2022] [Accepted: 07/27/2022] [Indexed: 12/18/2022]
|
8
|
Li D, Xu W, Wu Q, Zheng H, Li Y. Ascorbic acid intake is inversely associated with prevalence of depressive symptoms in US midlife women: A cross-sectional study. J Affect Disord 2022; 299:498-503. [PMID: 34942225 DOI: 10.1016/j.jad.2021.12.049] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 11/30/2021] [Accepted: 12/18/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND With the endocrine changes in menopausal transition period, associations between dietary ascorbic acid intake and depressive symptoms may be different. This investigation examined cross-sectional relations between dietary ascorbic acid intake of women and prevalence of depressive symptoms. METHODS This is a secondary analysis performed on a subsample of the Study of Women's Health Across the Nation (SWAN). Women enrolled had measures of CES-D depression scores and ascorbic acid intake. Regression models were used to study cross-sectional associations between ascorbic acid intake and depressive symptoms. RESULTS A total of 3088 women aged 42-52 years at baseline were included in the present study. Dietary ascorbic acid intake was inversely associated with depressive symptoms. The adjusted OR and 95% CI of depressive symptoms was 0.699 (0.524 - 0.934) in quartile 4 (the highest) versus quartile 1 (the lowest) of the ascorbic acid intake. Restricted cubic spline analyze showed a suggestion of L-shaped associations between ascorbic acid intake and depressive symptoms. CONCLUSIONS Ascorbic acid intake is inversely associated with prevalence of depressive symptoms in midlife women. Future prospective cohort studies are needed to confirm these findings.
Collapse
Affiliation(s)
- Di Li
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Wanzhou Xu
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Qing Wu
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Hongyun Zheng
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Yan Li
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
| |
Collapse
|
9
|
The effect of music therapy on menopausal symptoms and depression. Menopause 2022; 29:545-552. [DOI: 10.1097/gme.0000000000001941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
10
|
Chiang C, Pacyga DC, Strakovsky RS, Smith RL, James-Todd T, Williams PL, Hauser R, Meling DD, Li Z, Flaws JA. Urinary phthalate metabolite concentrations and serum hormone levels in pre- and perimenopausal women from the Midlife Women's Health Study. ENVIRONMENT INTERNATIONAL 2021; 156:106633. [PMID: 34004451 PMCID: PMC8380691 DOI: 10.1016/j.envint.2021.106633] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/30/2021] [Accepted: 05/06/2021] [Indexed: 05/09/2023]
Abstract
BACKGROUND Phthalate exposure is associated with altered reproductive function, but little is known about associations between phthalate and hormone levels in midlife women. METHODS This cross-sectional analysis includes 45-54-year-old pre- and perimenopausal women from Baltimore, MD and its surrounding counties enrolled in the Midlife Women's Health Study (n = 718). Serum and urine samples were collected from participants once a week for four consecutive weeks to span the menstrual cycle. Serum samples were assayed for estradiol, testosterone, progesterone, sex hormone binding globulin (SHBG), follicle-stimulating hormone (FSH), and anti-Müllerian hormone (AMH), and geometric means were calculated for each hormone across all four weeks. Urine samples were analyzed for nine phthalate metabolites from pools of one-to-four urine samples. Phthalate metabolite concentrations were specific gravity-adjusted and assessed as individual metabolites or as molar sums of metabolites from common parents (di(2-ethylhexyl) phthalate metabolites, ∑DEHP), exposure sources (plastic, ∑Plastics; personal care products, ∑PCP), biological activity (anti-androgenic, ∑AA), and sum of all metabolites (∑Phthalates). We used linear regression models to assess overall associations of phthalate metabolites with hormones, controlling for important demographic, lifestyle, and health factors. We also explored whether associations differed by menopause status, body mass index (BMI), and race/ethnicity. RESULTS Most participants were non-Hispanic white (67%) or black (29%), college-educated (65%), employed (80%), and had somewhat higher mean urinary phthalate metabolite concentrations than other U.S. women. Overall, the following positive associations were observed between phthalate metabolites and hormones: ∑DEHP (%Δ: 4.9; 95%CI: 0.5, 9.6), ∑Plastics (%Δ: 5.1; 95%CI: 0.3, 10.0), and ∑AA (%Δ: 7.8; 95%CI: 2.3, 13.6) with estradiol; MiBP (%Δ: 6.6; 95%CI: 1.5, 12.1) with testosterone; ∑DEHP (%Δ: 8.3; 95%CI: 1.5, 15.6), ∑Plastics (%Δ: 9.8; 95%CI: 2.4, 17.7), MEP (%Δ: 4.6; 95%CI: 0.1, 9.2), ∑PCP (%Δ: 6.0; 95%CI: 0.2, 12.2), ∑Phthalates (%Δ: 9.0; 95%CI: 2.1, 16.5), and ∑AA (%Δ: 12.9; 95%CI: 4.4, 22.1) with progesterone; and MBP (%Δ: 8.5; 95%CI: 1.2, 16.3) and ∑AA (%Δ: 9.0; 95%CI: 1.3, 17.4) with AMH. Associations of phthalate metabolites with hormones differed by menopause status (strongest in premenopausal women for estradiol, progesterone, and FSH), BMI (strongest in obese women for progesterone), and race/ethnicity (strongest in non-Hispanic white women for estradiol and AMH). CONCLUSIONS We found that phthalate metabolites were positively associated with several hormones in midlife women, and that some demographic and lifestyle characteristics modified these associations. Future longitudinal studies are needed to corroborate these findings in more diverse midlife populations.
Collapse
Affiliation(s)
- Catheryne Chiang
- Department of Comparative Biosciences, University of Illinois, Urbana, IL 61802, United States
| | - Diana C Pacyga
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48823, United States; Institute for Integrative Toxicology, Michigan State University, East Lansing, MI 48823, United States; Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI 48823, United States
| | - Rita S Strakovsky
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48823, United States; Institute for Integrative Toxicology, Michigan State University, East Lansing, MI 48823, United States
| | - Rebecca L Smith
- Institute for Genomic Biology, University of Illinois, Urbana, IL 61801, United States; Department of Pathobiology, University of Illinois, Urbana, IL 61802, United States
| | - Tamarra James-Todd
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States
| | - Paige L Williams
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States
| | - Russ Hauser
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States
| | - Daryl D Meling
- Department of Comparative Biosciences, University of Illinois, Urbana, IL 61802, United States
| | - Zhong Li
- Roy J. Carver Biotechnology Center, University of Illinois, Urbana, IL 61801, United States
| | - Jodi A Flaws
- Department of Comparative Biosciences, University of Illinois, Urbana, IL 61802, United States; Institute for Genomic Biology, University of Illinois, Urbana, IL 61801, United States.
| |
Collapse
|
11
|
Association of phthalate exposure and endogenous hormones with self-reported sleep disruptions: results from the Midlife Women's Health Study. ACTA ACUST UNITED AC 2021; 27:1251-1264. [PMID: 33110041 DOI: 10.1097/gme.0000000000001614] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Follicle-stimulating hormone and estradiol (E2) have been associated with sleep in midlife women, however, few studies have examined the association of other hormones or environmental chemical exposure such as phthalates, with self-reported sleep quality. We assessed the relationship of self-reported sleep with hormones and phthalates. METHODS In total, 762 women (aged 45-54 y, 459 premenopausal, and 303 perimenopausal) from the Midlife Women's Health Study answered self-reported questions regarding the frequency of sleep disturbances, insomnia, and restless sleep. Serum E2, progesterone, testosterone, serum hormone binding globulin, free E2 index, free testosterone index, E2:progesterone, and E2:testosterone were measured. Summary measures of phthalate mixtures, including the phthalates from plastic sources (sumPLASTIC), personal care products (sumPCP), di-(2-ethyhexyl) phthalate (sumDEHP), anti-androgenic phthalates (sumAA), and all phthalate metabolites measured (sumALL), were calculated from urinary phthalate metabolites. Ordinal logistic regression was used to fit each outcome sleep measure with all hormones and summary phthalates. RESULTS Progesterone and testosterone were significantly negatively associated with the frequency of sleep disturbances and insomnia. Free testosterone index was also negatively associated with insomnia frequency. E2:progesterone was positively associated with frequency of sleep disturbances and restless sleep in self-reported nonsmokers. SumPCP and sumALL were significantly negatively associated with frequency of sleep disturbances, insomnia, and restless sleep. SumDEHP and sumPLASTIC were negatively associated with insomnia frequency. Further, the direction of association between phthalates and sleep appears to be dependent on the quartile of phthalate exposure. All significant associations between phthalates and sleep were in self-reported nonsmokers or former smokers. CONCLUSIONS Our study supports previous literature that hormones beyond follicle-stimulating hormone and E2 are associated with sleep disruptions in menopause. Further, we are among the first to show that phthalate exposure is associated with sleep disruptions in midlife women.
Collapse
|
12
|
de Wit AE, Giltay EJ, de Boer MK, Bosker FJ, Cohn AY, Nolen WA, Kaiser UB, Joffe H, Penninx BW, Schoevers RA. Plasma androgens and the presence and course of depression in a large cohort of women. Transl Psychiatry 2021; 11:124. [PMID: 33579903 PMCID: PMC7881099 DOI: 10.1038/s41398-021-01249-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 01/07/2021] [Accepted: 01/14/2021] [Indexed: 01/05/2023] Open
Abstract
Major depressive disorder (MDD) has a higher prevalence in women with supraphysiologic androgen levels. Whether there is also an association between depression and androgen levels in the physiological range, is unknown. This study examined if women with current MDD have higher androgen levels compared to women who have never had MDD, and if androgen levels are associated with onset and remission of MDD. In 1659 women (513 current MDD, 754 remitted MDD, and 392 never MDD), baseline plasma levels of total testosterone, 5α-dihydrotestosterone, and androstenedione were determined with liquid chromatography-tandem mass spectrometry, and dehydroepiandrosterone-sulfate and sex hormone binding globulin (SHBG) with radioimmunoassays. Free testosterone was calculated. MDD status was assessed at baseline, and at 2 and 4 years follow-up. Women were aged between 18 and 65 years (mean age 41) with total testosterone levels in the physiological range (geometric mean 0.72 nmol/L [95% CI 0.27-1.93]). After adjusting for covariates and multiple testing, women with current MDD had a higher mean free testosterone than women who never had MDD (adjusted geometric mean 8.50 vs. 7.55 pmol/L, p = 0.0005), but this difference was not large enough to be considered clinically meaningful as it was consistent with statistical equivalence. Levels of other androgens and SHBG did not differ and were also statistically equivalent between the groups. None of the androgens or SHBG levels predicted onset or remission of MDD. Our findings support the idea that plasma androgens within the physiological range have no or only limited effects on depressive disorders in women.
Collapse
Affiliation(s)
- Anouk E. de Wit
- grid.4494.d0000 0000 9558 4598University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands
| | - Erik J. Giltay
- grid.10419.3d0000000089452978Leiden University Medical Center, Department of Psychiatry, Leiden, The Netherlands
| | - Marrit K. de Boer
- grid.4494.d0000 0000 9558 4598University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands
| | - Fokko J. Bosker
- grid.4494.d0000 0000 9558 4598University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands
| | - Aviva Y. Cohn
- Brigham and Women’s Hospital, Harvard Medical School, Department of Medicine, Boston, MA USA
| | - Willem A. Nolen
- grid.4494.d0000 0000 9558 4598University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands
| | - Ursula B. Kaiser
- Brigham and Women’s Hospital, Harvard Medical School, Department of Medicine, Boston, MA USA
| | - Hadine Joffe
- Brigham and Women’s Hospital, Harvard Medical School, Department of Psychiatry, Boston, MA USA ,Brigham and Women’s Hospital, Harvard Medical School, Connors Center for Women’s Health and Gender Biology, Boston, MA USA
| | - Brenda W.J.H. Penninx
- grid.12380.380000 0004 1754 9227Department of Psychiatry, Amsterdam UMC, VU University, Amsterdam, The Netherlands
| | - Robert A. Schoevers
- grid.4494.d0000 0000 9558 4598University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands
| |
Collapse
|
13
|
Willi J, Süss H, Grub J, Ehlert U. Prior depression affects the experience of the perimenopause - findings from the Swiss Perimenopause Study. J Affect Disord 2020; 277:603-611. [PMID: 32905912 DOI: 10.1016/j.jad.2020.08.062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 07/07/2020] [Accepted: 08/24/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND There is a prevalence peak of depression in the perimenopause, with this reproductive phase being considered a window of vulnerability due to major biopsychosocial changes. Depression has been associated with physical and psychosocial impairment. Prior depression has been shown to be a risk factor for the development of several somatic and mental diseases. We assume that women with prior depression will exhibit increased burdensome symptoms in the perimenopause compared to women without prior depression. METHODS A total of 135 perimenopausal women aged 40-56 years participated in the longitudinal Swiss Perimenopause Study. For the purpose of this investigation, a cross-sectional design was chosen. A wide range of validated psychosocial questionnaires were used to compare women with and without prior depression regarding their experience of the perimenopause. Findings were statistically adjusted for multiple testing. RESULTS Women with prior depression showed significantly more depressive symptoms (U = 1215.5, p < .01), more menopausal symptoms (U = 1395.0, p < .01), and more sleep disturbances (U = 1583.5, p < .05) than women without prior depression. Moreover, women with a history of depression reported lower subjective mental health (U = 1573.0, p < 05) and felt more isolated (U = 1524.0, p < .05) than those without prior depression. LIMITATIONS Self-report data may affect the results. Furthermore, due to the cross-sectional design, causality cannot be inferred. CONCLUSIONS Prior depression affects women's experience of the perimenopause. Women with prior depression exhibit significantly more negative health outcomes in the perimenopause than those without prior depression.
Collapse
Affiliation(s)
- Jasmine Willi
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; University Research Priority Program Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
| | - Hannah Süss
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; University Research Priority Program Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
| | - Jessica Grub
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; University Research Priority Program Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
| | - Ulrike Ehlert
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; University Research Priority Program Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland.
| |
Collapse
|
14
|
Alam MM, Ahmed S, Dipti RK, Siddiquee REJ, Hawlader MDH. The prevalence and associated factors of depression during pre-, peri-, and post-menopausal period among the middle-aged women of Dhaka city. Asian J Psychiatr 2020; 54:102312. [PMID: 32795954 DOI: 10.1016/j.ajp.2020.102312] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 06/21/2020] [Accepted: 07/10/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND Depression is a serious mental health issue and a major concern among middle-aged women, especially during the menopause transition time. This study aimed to determine the prevalence and associated factors of depression among the middle-aged women of the menopause transition in Dhaka. METHODOLOGY A cross-sectional study was conducted among 41 to 60 years older women in Dhaka city using a multistage cluster sampling technique and face to face interview. RESULT In total 326 middle-aged women participated in the study, and among them, 30.4% had major depression. No statistically significant association was observed between menopause status and major depression. However, peri-(34.2%) and post-menopausal (33.3%) groups were more depressed compared to pre-menopausal (26.8%) groups. Our adjusted analysis indicates, marital status (p = 0.004), having salaried job (p < 0.001), number of offspring (p = 0.003), sedentary hours (p = 0.002), smoking habit (p = 0.012), hypertension (p = 0.012), chronic disease other than diabetes/hypertension (p = 0.006), vasomotor symptoms (p = 0.004) and sleep problem (p = 0.007) were significantly associated with depression status. CONCLUSION The study result indicates a high prevalence of major depression among middle-aged Bangladeshi women during the menopause transition. Therefore, depression should be routinely evaluated among middle-aged women for the monitoring and prevention of depression.
Collapse
Affiliation(s)
- Mohammad Morshad Alam
- Health, Nutrition and Population Global Practice, The World Bank, Agargaon, Dhaka, 1207, Bangladesh; Graduex Research Group, Dhaka, 1209, Bangladesh.
| | - Shakil Ahmed
- Department of Public Health, North South University, Dhaka-1229, Bangladesh.
| | | | | | | |
Collapse
|
15
|
Willi J, Ehlert U. Symptoms assessed in studies on perimenopausal depression: A narrative review. SEXUAL & REPRODUCTIVE HEALTHCARE 2020; 26:100559. [PMID: 33010665 DOI: 10.1016/j.srhc.2020.100559] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 09/07/2020] [Accepted: 09/22/2020] [Indexed: 12/19/2022]
Abstract
The menopausal transition constitutes a phase of major biopsychosocial changes associated with an elevated risk for the development of depression. Perimenopausal depression is highly prevalent and usually characterized by core symptoms of a major depressive disorder combined with menopausal complaints such as vasomotor symptoms or other physical complaints. However, a distinct definition of the condition is lacking. The aim of this review is to portray the symptoms assessed in studies on perimenopausal depression in order to provide relevant information on the current understanding of this condition. A literature search was conducted using the databases PubMed, Cochrane Library, and PsycINFO. A total of 37 studies were included. Various assessment tools have been used to measure symptoms related to perimenopausal depression. Fifteen symptoms were identified. Depressed mood was assessed across all studies. Low energy or sleep disturbances, as acknowledged symptoms of a major depressive disorder, were surveyed in most studies. However, the assessment of menopausal complaints was rather heterogeneous. While vasomotor symptoms were often measured, other menopausal symptoms such as mood swings or pain were investigated less frequently. Sexual problems were only rarely assessed. Studies on perimenopausal depression regularly include the assessment of core symptoms of a major depressive disorder, but the assessment of menopausal complaints is inconsistent. While certain symptoms are commonly measured, others are not assessed. Such inconsistencies underline an ambiguous understanding of perimenopausal depression, which in turn affects the evaluation and treatment of the condition. Thus, the use of the existing guidelines on perimenopausal depression is recommended.
Collapse
Affiliation(s)
- Jasmine Willi
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; University Research Priority Program Dynamics of Healthy Aging Research Priority Program, University of Zurich, Zurich, Switzerland
| | - Ulrike Ehlert
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; University Research Priority Program Dynamics of Healthy Aging Research Priority Program, University of Zurich, Zurich, Switzerland.
| |
Collapse
|
16
|
Li D, Tong Y, Li Y. Dietary Fiber Is Inversely Associated With Depressive Symptoms in Premenopausal Women. Front Neurosci 2020; 14:373. [PMID: 32435179 PMCID: PMC7218088 DOI: 10.3389/fnins.2020.00373] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 03/26/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND An inverse association between dietary fiber intake and depressive symptoms was reported in the general population, but this association is unstudied in midlife women. This study was designed to investigate the association of dietary fiber intake with depressive symptoms in midlife women. METHODS Analyses for this cross-sectional study were performed on baseline assessment of the Study of Women's Health Across the Nation (SWAN). Linear regressions were used to examine the association of fiber intake with Center for Epidemiological Studies-Depression (CES-D) score. Logistic regression and restricted cubic spline analyses were used to examine the association between fiber intake and depressive symptoms (CES-D score ≥ 16). RESULTS A total of 3054 midlife women in our study were stratified into premenopausal women and early perimenopausal women by menstrual bleeding patterns. In premenopausal women, dietary fiber intake was inversely associated with CES-D scores in unadjusted, age-, education-, race/ethnicity-, total family income-, BMI-, sport-, use of antidepressant-, dietary total caloric intake-, SHBG-, and FSH-adjusted linear regression model. The fully adjusted regression coefficient with 95% confidence intervals (CIs) of fiber intakes was -0.146 (-0.235, -0.058) for CES-D score. Fiber intake was inversely associated with depressive symptoms (CES-D score ≥ 16) in crude and fully adjusted logistic regression model. The fully adjusted odds ratios (ORs) with 95% CI of depressive symptoms was 0.483 (0.314-0.745) in quartile 4 compared with quartile 1 for fiber intake. However, in early perimenopausal women, dietary fiber intake was not statistically significantly associated with depressive symptoms. CONCLUSION Dietary fiber is inversely associated with depressive symptoms in premenopausal women, but not in early perimenopausal women.
Collapse
Affiliation(s)
- Di Li
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yongqing Tong
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yan Li
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, China
| |
Collapse
|
17
|
Raglan GB, Schulkin J, Micks E. Depression during perimenopause: the role of the obstetrician-gynecologist. Arch Womens Ment Health 2020; 23:1-10. [PMID: 30758732 DOI: 10.1007/s00737-019-0950-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 01/31/2019] [Indexed: 02/07/2023]
Abstract
Depression in women is more common during perimenopause (the transition to menopause) than at other times in the life cycle. Symptoms of depression may be different in perimenopausal women compared to younger or older women, and are often dismissed as part of normal menopause. This is an expert narrative review. There are several evidence-based screening modalities which can be integrated into routine women's health visits, and can facilitate distinguishing between depression and normal perimenopausal symptoms. There is emerging evidence regarding the effect of hormonal changes on the development of perimenopausal depression and its optimal treatment, though critical research gaps remain. Obstetrician-gynecologists and other primary care providers play a vital role in the detection and management of depression in women. Providers caring for women during perimenopause have a unique opportunity to diagnose depression in their patients and identify appropriate treatment options.
Collapse
Affiliation(s)
- Greta B Raglan
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Jay Schulkin
- Department of Obstetrics and Gynecology, University of Washington School of Medicine, 1959 NE Pacific St., Box 356460, Seattle, WA, 98195-6460, USA
| | - Elizabeth Micks
- Department of Obstetrics and Gynecology, University of Washington School of Medicine, 1959 NE Pacific St., Box 356460, Seattle, WA, 98195-6460, USA.
| |
Collapse
|
18
|
Fu JX, Luo Y, Chen MZ, Zhou YH, Meng YT, Wang T, Qin S, Xu C. Associations among menopausal status, menopausal symptoms, and depressive symptoms in midlife women in Hunan Province, China. Climacteric 2020; 23:259-266. [DOI: 10.1080/13697137.2019.1703936] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- J.-X. Fu
- Xiangya Nursing School of Central South University, Changsha, China
| | - Y. Luo
- Xiangya Nursing School of Central South University, Changsha, China
| | - M.-Z. Chen
- Xiangya Nursing School of Central South University, Changsha, China
| | - Y.-H. Zhou
- Xiangya Nursing School of Central South University, Changsha, China
| | - Y.-T. Meng
- Xiangya Nursing School of Central South University, Changsha, China
| | - T. Wang
- Xiangya Nursing School of Central South University, Changsha, China
| | - S. Qin
- Xiangya Nursing School of Central South University, Changsha, China
| | - C. Xu
- Xiangya Nursing School of Central South University, Changsha, China
| |
Collapse
|
19
|
Li D, Liang H, Tong Y, Li Y. Association of dietary n-3 polyunsaturated fatty acids intake with depressive symptoms in midlife women. J Affect Disord 2020; 261:164-171. [PMID: 31630038 DOI: 10.1016/j.jad.2019.10.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 09/05/2019] [Accepted: 10/09/2019] [Indexed: 01/13/2023]
Abstract
BACKGROUND To study the association of n-3 polyunsaturated fatty acid (n-3 PUFA) intake from diet with depressive symptoms in midlife women. METHODS Data for this cross-sectional study were retrieved from baseline assessment of the Study of Women's Health Across the Nation (SWAN). Logistic regression and restricted cubic spline models were performed to examine the association n-3 PUFA intake with depressive symptoms. RESULTS A total of 3054 women aged 42-52 years were included in the present study. In overall midlife women, n-3 PUFA intake was not significantly associated with depressive symptoms (CES-D score ≥16) after adjustment for potential confounders. In early perimenopausal women, n-3 PUFA intake was inversely associated with depressive symptoms after adjustment for potential confounders. The fully adjusted OR with 95% CI of depressive symptoms were 0.062 (0.009-0.457) in the highest quartile (n-3 PUFAs intake was categorized by quartiles) compared with the lowest quartile for n-3 PUFA intake. Restricted cubic spline analyses showed that n-3 PUFA intake were dose-response inversely associated with depressive symptoms in early perimenopausal women. However, in premenopausal women, no significant association between depressive symptoms and n-3 PUFA intake was observed. LIMITATIONS This was a cross-sectional study, limiting causal inferences. CONCLUSION Dietary n-3 PUFA may be inversely associated with depressive symptoms in early perimenopausal women, but not in premenopausal women.
Collapse
Affiliation(s)
- Di Li
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, China
| | - Hua Liang
- Department of Gynecology and Obstetrics, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, China
| | - Yongqing Tong
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, China
| | - Yan Li
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, China.
| |
Collapse
|
20
|
Associations of dietary trans fatty acid intake with depressive symptoms in midlife women. J Affect Disord 2020; 260:194-199. [PMID: 31499375 DOI: 10.1016/j.jad.2019.09.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 07/12/2019] [Accepted: 09/01/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND To study the association of trans fatty acid intake from diet with depressive symptoms in midlife women. METHODS Data for this cross-sectional study were retrieved from baseline assessment of the Study of Women's Health Across the Nation (SWAN). Linear regression, logistic regression and restricted cubic spline models were performed to examine the association trans fatty acid intake with depressive symptoms. RESULTS A total of 3095 women aged 42-52 years were included in the present study. Trans fatty acid intake was positively associated with CES-D (Center for Epidemiological Studies-Depression) scores in unadjusted, age-, race/ethnicity-, total family income- and education-adjusted and fully adjusted linear regression model. The fully adjusted regression coefficient with 95% confidence intervals (CIs) of trans fatty acid intake were 0.146 (0.047-0.246) for CES-D score. Trans fatty acid intake was positively associated with depressive symptoms (CES-D score ≥16) in each logistic regression model. The fully adjusted odds ratios (ORs) with 95% CI of depressive symptoms were 1.410 (1.019-1.951) in quartile 4 compared with quartile 1 for trans fatty acid intake. Sensitivity analyses showed that the association between trans fatty acid and depressive symptoms were not affected by use of antidepressant. Stratified analysis showed that, in fully adjusted model, the trans fatty acid intake was not significantly associated with depressive symptoms in early perimenopausal women. LIMITATIONS This was a cross-sectional study, limiting causal inferences. CONCLUSION Trans fatty acid may be positively associated with depressive symptoms in premenopausal women, but not in early perimenopausal women.
Collapse
|
21
|
Li D, Tong Y, Li Y. Associations between dietary oleic acid and linoleic acid and depressive symptoms in perimenopausal women: The Study of Women's Health Across the Nation. Nutrition 2019; 71:110602. [PMID: 31837641 DOI: 10.1016/j.nut.2019.110602] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Revised: 08/24/2019] [Accepted: 10/05/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES The aim of this study was to review the association of dietary intake of oleic and linoleic acids (OA and LA, respectively) with depressive symptoms in perimenopausal women. METHODS This cross-sectional study used data from the Study of Women's Health Across the Nation (SWAN). Linear and logistic regressions and restricted cubic spline models were performed to examine the association of intake of OA and LA with depression. RESULTS We included 2793 women 42 to 52 y of age in the present study. Intake of the two acids was positively associated with the Center for Epidemiologic Studies Depression Scale (CES-D) scores in unadjusted and age-, race/ethnicity-, total family income- and education-adjusted linear regression model. The fully adjusted regression coefficients were β = 0.089 and β = 0.145 for oleic and linoleic acid intake, respectively. OA and LA intake was positively associated with depressive symptoms (CES-D score ≥16) in unadjusted and age-, race/ethnicity-, total family income- and education-adjusted logistic regression model. The fully adjusted odds ratios (ORs) with 95% confidence intervals (CIs) of depressive symptoms were 1.994 (1.298-3.063) and 1.592 (1.047-2.421) for the highest versus lowest quartile of intake of OA and LA, respectively. CONCLUSION Intake of OA and LA may be positively associated with depressive symptoms in perimenopausal women.
Collapse
Affiliation(s)
- Di Li
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, China.
| | - Yongqing Tong
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yan Li
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, China.
| |
Collapse
|
22
|
Tang R, Luo M, Li J, Peng Y, Wang Y, Liu B, Liu G, Wang Y, Lin S, Chen R. Symptoms of anxiety and depression among Chinese women transitioning through menopause: findings from a prospective community-based cohort study. Fertil Steril 2019; 112:1160-1171. [DOI: 10.1016/j.fertnstert.2019.08.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 07/20/2019] [Accepted: 08/06/2019] [Indexed: 10/25/2022]
|
23
|
Abstract
PURPOSE OF REVIEW We review recent data on bipolar disorder in menopausal-aged women, particularly in women undergoing the menopausal transition (MT). We discuss evidence on the severity of symptoms in bipolar women during the MT. Moreover, we address two factors in bipolar disorder and menopausal research: standardized menopausal staging and women's conceptualization of their menopausal and bipolar symptoms. RECENT FINDINGS While there are few studies within the last 5 years on bipolar women undergoing the MT, new evidence suggest that mood symptoms in women worsen with progression through the MT. Consistent use of the standardized menopausal staging system can facilitate understanding of the timing of worsening symptoms. Moreover, whether women conceptualize their symptoms as arising from their MT or bipolar disorder can influence whether they seek hormonal therapy or psychiatric treatment, respectively. The MT is a potential time for mood instability in vulnerable women, which can manifest as first-onset development of bipolar disorder or increased symptom severity in women with pre-existing bipolar disorder. Adoption of a standardized menopausal staging may offer novel frameworks for understanding of the role of the MT in bipolar disorder.
Collapse
Affiliation(s)
- Dawn Truong
- University of Massachusetts Medical School, Worcester, MA, USA
| | - Wendy Marsh
- Department of Psychiatry, University of Massachusetts Memorial Medical Center, University of Massachusetts Medical School, 55 Lake Avenue, North, Worcester, MA, 01655, USA.
| |
Collapse
|
24
|
Guidelines for the evaluation and treatment of perimenopausal depression: summary and recommendations. Menopause 2019; 25:1069-1085. [PMID: 30179986 DOI: 10.1097/gme.0000000000001174] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
There is a new appreciation of the perimenopause - defined as the early and late menopause transition stages as well as the early postmenopause - as a window of vulnerability for the development of both depressive symptoms and major depressive episodes. However, clinical recommendations on how to identify, characterize and treat clinical depression are lacking. To address this gap, an expert panel was convened to systematically review the published literature and develop guidelines on the evaluation and management of perimenopausal depression. The areas addressed included: 1) epidemiology; 2) clinical presentation; 3) therapeutic effects of antidepressants; 4) effects of hormone therapy; and 5) efficacy of other therapies (eg, psychotherapy, exercise, and natural health products). Overall, evidence generally suggests that most midlife women who experience a major depressive episode during the perimenopause have experienced a prior episode of depression. Midlife depression presents with classic depressive symptoms commonly in combination with menopause symptoms (ie, vasomotor symptoms, sleep disturbance), and psychosocial challenges. Menopause symptoms complicate, co-occur, and overlap with the presentation of depression. Diagnosis involves identification of menopausal stage, assessment of co-occurring psychiatric and menopause symptoms, appreciation of the psychosocial factors common in midlife, differential diagnoses, and the use of validated screening instruments. Proven therapeutic options for depression (ie, antidepressants, psychotherapy) are the front-line treatments for perimenopausal depression. Although estrogen therapy is not approved to treat perimenopausal depression, there is evidence that it has antidepressant effects in perimenopausal women, particularly those with concomitant vasomotor symptoms. Data on estrogen plus progestin are sparse and inconclusive.
Collapse
|
25
|
Li D, Li Y. Associations of α-carotenoid and β-carotenoid with depressive symptoms in late midlife women. J Affect Disord 2019; 256:424-430. [PMID: 31229931 DOI: 10.1016/j.jad.2019.06.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 04/09/2019] [Accepted: 06/02/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND To study the association of α-carotenoid and β-carotenoid intakes from diet with depressive symptoms. METHODS Cross-sectional study used data from the Study of Women's Health Across the Nation (SWAN). Linear regression, logistic regression and restricted cubic spline models were performed to examine the association α-carotenoid and β-carotenoid intakes with depression. RESULTS A total of 2762 women aged 42-52 years were included in the present study. α-carotenoid and β-carotenoid intakes were inversely associated with CES-D scores in unadjusted and age-, race/ethnicity-, total family income- and sex hormone binding globulin-adjusted linear regression model. The multivariate adjusted regression coefficient with 95% confidence intervals (CIs) of CES-D score were -2.933 (-4.242, -1.623) and -0.153 (-0.282, -0.024) for α-carotenoid and β-carotenoid intakes. α-carotenoid and β-carotenoid intakes were inversely associated with high CES-D score (≥16) in unadjusted and age-, race/ethnicity-, total family income- and sex hormone binding globulin-adjusted logistic regression model. The multivariate adjusted Odds ratios (ORs) with 95% confidence intervals (CIs) of high CES-D score (≥16) were 0.718 (0.553-0.933) and 0.742 (0.571-0.964) for the highest versus lowest quartile of α-carotenoid and β-carotenoid intakes, respectively. However, association was not statistically significant between α-carotene and β-carotene intakes and society/work damage due to emotion problem. LIMITATIONS This was a cross-sectional study, limiting causal inferences. Assessment of CES-D was based on a self-report scale. CONCLUSION α-carotenoid and β-carotenoid intakes may be inversely associated with depressive symptoms in late midlife women.
Collapse
Affiliation(s)
- Di Li
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, China.
| | - Yan Li
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, China.
| |
Collapse
|
26
|
de Oliveira NG, Teixeira IT, Theodoro H, Branco CS. Dietary total antioxidant capacity as a preventive factor against depression in climacteric women. Dement Neuropsychol 2019; 13:305-311. [PMID: 31555403 PMCID: PMC6753913 DOI: 10.1590/1980-57642018dn13-030007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Depression is characterized by physical or psychological distress and in many cases can lead to suicide.
Collapse
Affiliation(s)
- Natiani Gonçalves de Oliveira
- Universidade de Caxias do Sul Área do Conhecimento de Ciências da Vida Caxias do SulRS Brasil Área do Conhecimento de Ciências da Vida, Universidade de Caxias do Sul, Caxias do Sul, RS, Brasil
| | - Iranice Taís Teixeira
- Universidade de Caxias do Sul Área do Conhecimento de Ciências da Vida Caxias do SulRS Brasil Área do Conhecimento de Ciências da Vida, Universidade de Caxias do Sul, Caxias do Sul, RS, Brasil
| | - Heloísa Theodoro
- Universidade de Caxias do Sul Área do Conhecimento de Ciências da Vida Caxias do SulRS Brasil Área do Conhecimento de Ciências da Vida, Universidade de Caxias do Sul, Caxias do Sul, RS, Brasil
| | - Catia Santos Branco
- Universidade de Caxias do Sul Área do Conhecimento de Ciências da Vida Caxias do SulRS Brasil Área do Conhecimento de Ciências da Vida, Universidade de Caxias do Sul, Caxias do Sul, RS, Brasil.,Universidade de Caxias do Sul Instituto de Biotecnologia Laboratório de Estresse Oxidativo e Antioxidantes Caxias do SulRS Brasil Laboratório de Estresse Oxidativo e Antioxidantes, Instituto de Biotecnologia, Universidade de Caxias do Sul, Caxias do Sul, RS, Brasil
| |
Collapse
|
27
|
Maki PM, Kornstein SG, Joffe H, Bromberger JT, Freeman EW, Athappilly G, Bobo WV, Rubin LH, Koleva HK, Cohen LS, Soares CN. Guidelines for the Evaluation and Treatment of Perimenopausal Depression: Summary and Recommendations. J Womens Health (Larchmt) 2019; 28:117-134. [DOI: 10.1089/jwh.2018.27099.mensocrec] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
- Pauline M. Maki
- Department of Psychiatry and Department of Psychology, University of Illinois at Chicago, Chicago Illinois
| | - Susan G. Kornstein
- Department of Psychiatry and Institute of Women's Health, Virginia Commonwealth University, Richmond, Virginia
| | - Hadine Joffe
- Connors Center for Women's Health and Department of Psychiatry, Brigham and Women's Hospital and Dana Farber Cancer Institute/Harvard Medical School, Boston, Massachusetts
| | - Joyce T. Bromberger
- Department of Epidemiology, Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Ellen W. Freeman
- Department of Obstetrics and Gynecology and Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Geena Athappilly
- Edith Nourse Rogers Memorial Veterans Hospital, Bedford Massachusetts; Harvard Medical School, Boston Massachusetts
| | - William V. Bobo
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Leah H. Rubin
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Lee S. Cohen
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Claudio N. Soares
- Department of Psychiatry, Queen's University School of Medicine, Ontario Canada
| | | |
Collapse
|
28
|
Bromberger JT, Epperson CN. Depression During and After the Perimenopause: Impact of Hormones, Genetics, and Environmental Determinants of Disease. Obstet Gynecol Clin North Am 2018; 45:663-678. [PMID: 30401549 PMCID: PMC6226029 DOI: 10.1016/j.ogc.2018.07.007] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Vulnerability to depression is increased across the menopause transition and in the early years after the final menstrual period. Clinicians should systematically screen women in this age group; if depressive symptoms or disorder are present, treatment of depression should be initiated. Potential treatments include antidepressants for moderate to severe symptoms, psychotherapy to target psychological and interpersonal factors, and hormone therapy for women with first-onset major depressive disorder or elevated depressive symptoms and at low risk for adverse effects. Behavioral interventions can improve physical activity and sleep patterns.
Collapse
Affiliation(s)
- Joyce T Bromberger
- Department of Epidemiology, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15213, USA; Department of Psychiatry, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15213, USA.
| | - Cynthia Neill Epperson
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Philadelphia, PA, 19104, USA; Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Philadelphia, PA, 19104, USA; Penn PROMOTES Research on Sex and Gender in Health, University of Pennsylvania, 3535 Market Street, Philadelphia, PA, 19104, USA
| |
Collapse
|
29
|
A Cross-sectional Study of Reported Exercise and Medium-Term Weight Loss Following Laparoscopic Bariatric Surgery. Obes Surg 2018; 28:3923-3928. [PMID: 30069860 DOI: 10.1007/s11695-018-3434-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Exercise is a strong determinant of prolonged weight loss in non-surgical patients. Studies evaluating the impact of exercise beyond the first year after bariatric surgery are lacking. We analyzed the relationship between reported intentional exercise and medium-term weight loss following bariatric surgery. METHODS Patients who underwent bariatric surgery from 2007 thru 2013 completed a follow-up telephone survey and were separated into groups based on reported weekly exercise, i.e., < 90 min week-1, 90-200 min week-1, and > 200 min week-1. Standardized weight loss measures including percent of total weight loss, percent of excess body mass index (BMI) loss, percent of excess weight loss, and change in BMI were compared using analysis of covariance, with years from surgery as the covariant. RESULTS A total of 872 patients were included in this study (age = 48 ± 10 years; BMI = 48 ± 7 kg/m2), with a mean post-surgery follow-up of 39 ± 14 months. Patients reporting > 200 min week-1 of planned exercise had greater weight loss than those who did less than 90 min week-1 (p < 0.05). No significant difference was found between those who reported less than 90 min week-1and those reporting between 91 and 200 min week-1. CONCLUSIONS This study suggests that regular exercise in excess of 200 min week-1 is associated with greater medium-term weight loss following laparoscopic bariatric surgery. Multidisciplinary bariatric surgery teams should consider emphasizing exercise at this level to help patients achieve optimal weight loss.
Collapse
|
30
|
Tsai KW, Lin SC, Koo M. Correlates of depressive symptoms in late middle-aged Taiwanese women: findings from the 2009 Taiwan National Health Interview Survey. BMC WOMENS HEALTH 2017; 17:103. [PMID: 29121892 PMCID: PMC5679489 DOI: 10.1186/s12905-017-0461-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 10/31/2017] [Indexed: 01/06/2023]
Abstract
Background Previous studies have shown that depressive symptoms in middle-aged women were associated with a number of factors such as climacteric symptoms. Nevertheless, studies based on population-based data with a wide range of potential correlates are still scarce. Therefore, the aim of this study was to investigate the correlates of depressive symptoms in late middle-aged Taiwanese women using data from a nationally-representative, population-based survey. Methods Women aged 50.0–65.0 years were identified from the dataset of the 2009 Taiwan National Health Interview Survey. The outcome measure was depressive symptoms in the past week, evaluated using the Center for Epidemiologic Studies Short Depression Scale (CES-D 10) with a cut-off score of 10 or greater. Univariate and multiple logistic regression analyses were used to evaluate the correlates of depressive symptoms. Results The mean age of the 533 respondents was 56.7 years. Depressive symptoms were present in 53 respondents (9.9%). Multiple logistic regression analysis revealed that an education level of elementary school or below (adjusted odds ratio [AOR] = 3.19, P = 0.003), nulliparity (AOR = 8.10, P = 0.001), living alone (AOR = 5.47, P = 0.003), never having worked (AOR = 4.14, P = 0.008), lack of regular exercise (AOR = 3.01, P = 0.003), a perceived health status of fair or bad (AOR = 4.34, P < 0.001), and somatic climacteric symptoms (AOR = 2.32, P = 0.012) were independent and significant factors of depressive symptoms in late middle-aged Taiwanese women. Conclusions Findings from this secondary analysis of a population-based survey suggested independent associations of somatic climacteric symptoms, and a number of socio-demographic and health-related factors with depressive symptoms in late middle-aged Taiwanese women.
Collapse
Affiliation(s)
- Kun-Wei Tsai
- Division of Geriatrics, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan
| | - Shih-Chun Lin
- Division of Geriatrics, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan
| | - Malcolm Koo
- Department of Medical Research, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan. .,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
| |
Collapse
|
31
|
Colvin A, Richardson GA, Cyranowski JM, Youk A, Bromberger JT. The role of family history of depression and the menopausal transition in the development of major depression in midlife women: Study of women's health across the nation mental health study (SWAN MHS). Depress Anxiety 2017; 34:826-835. [PMID: 28489293 PMCID: PMC5585035 DOI: 10.1002/da.22651] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 03/13/2017] [Accepted: 04/21/2017] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND This study evaluated whether family history of depression predicts major depression in midlife women above and beyond static risk factors (such as personal history of depression prior to midlife) and risks that may change dynamically across midlife (such as menopausal, psychosocial, and health profiles). METHODS Participants were 303 African American and Caucasian women (42-52 years at baseline) recruited into the Study of Women's Health across the Nation (SWAN) Mental Health Study (MHS) in Pittsburgh. Major depression was assessed annually with Structured Clinical Interviews for DSM-IV. Family mental health history was collected at the ninth or tenth annual follow-up. Random effects logistic regression was used to assess the relationship between family history of depression and midlife depression, controlling for baseline sociodemographic characteristics and time-varying risk factors. RESULTS Family history of depression was associated with midlife depression after adjusting for participant's history of major depression prior to midlife, trait anxiety and baseline age, and time-varying menopausal status, body mass index, very upsetting life events, and chronic difficulties (OR = 2.24, 95% CI = 1.17-4.29, P = .02). Higher odds of major depression were found when women were late perimenopausal or postmenopausal relative to when they were premenopausal or early perimenopausal (OR = 3.01, 95% CI = 1.76-5.15, P < .0001). However, menopausal status was only associated with major depression among women without a family history. CONCLUSIONS Family history of depression predicts major depression in midlife women independent of the menopausal transition and other time-varying covariates. Notably, the menopausal transition was associated with increased risk only among women without a family history of depression.
Collapse
Affiliation(s)
- Alicia Colvin
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
| | - Gale A. Richardson
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA
| | | | - Ada Youk
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA
| | - Joyce T. Bromberger
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA,Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA
| |
Collapse
|
32
|
Kai Y, Nagamatsu T, Kitabatake Y, Sensui H. Effects of stretching on menopausal and depressive symptoms in middle-aged women: a randomized controlled trial. Menopause 2016; 23:827-32. [PMID: 27300113 PMCID: PMC4961267 DOI: 10.1097/gme.0000000000000651] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 02/10/2016] [Accepted: 02/10/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Exercise may help alleviate menopausal and depressive symptoms in middle-aged women, but sufficient evidence does not currently exist to fully support this theory. Whereas frequent moderate- to vigorous-intensity exercise may be associated with the risk of menopausal hot flashes, light-intensity exercise, such as stretching, is not likely to increase the occurrence of hot flashes. Little is, however, known about the effects of light-intensity exercise on menopausal and depressive symptoms. We examined the effects of a 3-week stretching program on the menopausal and depressive symptoms in middle-aged, Japanese women. METHODS Forty Japanese women, aged 40 to 61 years, were recruited (mean age, 51.1 ± 7.3 y). The participants were randomly assigned to either a stretching or a control group. The stretching group (n = 20) participated in a 3-week intervention program that involved 10 minutes of daily stretching, just before bedtime. The control group (n = 20) was assigned to a waiting list. Menopausal symptoms were evaluated using the Simplified Menopausal Index, which measures vasomotor, psychological, and somatic symptoms. Depressive symptoms were assessed using the Self-Rating Depression Scale. RESULTS The compliance rate was 75.8% during the 3-week intervention program. The total Simplified Menopausal Index scores, including the vasomotor, psychological, and somatic symptoms, and the Self-Rating Depression Scale scores significantly decreased in the stretching group compared with that in the control group. No adverse events, including increased hot flashes, were reported by the participants during the study period. CONCLUSIONS These findings suggest that 10 minutes of stretching before bedtime decreases menopausal and depressive symptoms in middle-aged, Japanese women.
Collapse
Affiliation(s)
- Yuko Kai
- Physical Fitness Research Institute, Meiji Yasuda Life Foundation of Health and Welfare, Tokyo, Japan
| | - Toshiya Nagamatsu
- Physical Fitness Research Institute, Meiji Yasuda Life Foundation of Health and Welfare, Tokyo, Japan
| | | | - Hiroomi Sensui
- Physical Fitness Research Institute, Meiji Yasuda Life Foundation of Health and Welfare, Tokyo, Japan
| |
Collapse
|
33
|
Hashemi S, Ramezani Tehrani F, Mohammadi N, Rostami Dovom M, Torkestani F, Simbar M, Azizi F. Comparison of Metabolic and Hormonal Profiles of Women With and Without Premenstrual Syndrome: A Community Based Cross-Sectional Study. Int J Endocrinol Metab 2016; 14:e28422. [PMID: 27679647 PMCID: PMC5035673 DOI: 10.5812/ijem.28422] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 11/16/2015] [Accepted: 11/17/2015] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Premenstrual syndrome (PMS) is reported by up to 85% of women of reproductive age. Although several studies have focused on the hormone and lipid profiles of females with PMS, the results are controversial. OBJECTIVES This study was designed to investigate the association of hormonal and metabolic factors with PMS among Iranian women of reproductive age. MATERIALS AND METHODS This study was a community based cross-sectional study. Anthropometric measurements, biochemical parameters, and metabolic disorders were compared between 354 women with PMS and 302 healthy controls selected from among 1126 women of reproductive age who participated in the Iranian PCOS prevalence study. P values < 0.05 were considered significant. RESULTS Prolactin (PRL) and triglycerides (TG) were significantly elevated in women with PMS, whereas their testosterone (TES), high density lipoprotein (HDL) and 17-hydroxyprogesterone (17-OHP) levels were significantly less than they were in women without the syndrome (P < 0.05). After adjusting for age and body mass index (BMI), linear regression analysis demonstrated that for every one unit increase in PMS score there was 12% rise in the probability of having metabolic syndrome (P = 0.033). CONCLUSIONS There was a significant association between PMS scores and the prevalence of metabolic syndrome. Further studies are needed to confirm and validate the relationships between lipid profile abnormalities and metabolic disorders with PMS.
Collapse
Affiliation(s)
- Somayeh Hashemi
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Fahimeh Ramezani Tehrani, Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P. O. Box: 193954763, Tehran, IR Iran. Tel: +98-2122409309, Fax: +98-2122402463, E-mail:
| | - Nader Mohammadi
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Marzieh Rostami Dovom
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | | | - Masumeh Simbar
- Department of Reproductive Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| |
Collapse
|
34
|
Zang H, He L, Chen Y, Ge J, Yao Y. The association of depression status with menopause symptoms among rural midlife women in China. Afr Health Sci 2016; 16:97-104. [PMID: 27358619 DOI: 10.4314/ahs.v16i1.13] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE This study aims to evaluate the association of depression with menopausal status and some menopause symptoms (vasomotor symptoms and poor sleep). METHODS A total of 743 participants aged 40-60 years were recruited. Depression status was evaluated by using Self-Rating Depression Scale (SDS). Sleep quality and vasomotor symptoms were evaluated by specific symptoms questionnaire. RESULTS The prevalence of depression among participants was 11.4%. Depression was found more likely to occur in participants with poor sleep (OR, 6.02; 95%CI, 3.61, 10.03) or with vasomotor symptoms (VMS) (OR, 2.03; 95%CI, 1.20, 3.44) after controlling for age, education level, marital status, menopause status, monthly family income and chronic diseases. Menopause status was not associated with depression. Stratification analysis showed a significant association between poor sleep and depression across different menopause stages, while VMS were associated with depression only in premenopausal status. CONCLUSION The majority of Chinese rural midlife women do not experience depression. The relationship between depression, VMS and sleep disturbances tends to change with menopausal status in Chinese rural midlife women.
Collapse
|
35
|
Kwon HJ, Yoon MS. Relationship of Depression, Stress, and Self-Esteem with Oral Health-Related Quality of Life of Middle-Aged Women. ACTA ACUST UNITED AC 2015. [DOI: 10.17135/jdhs.2015.15.6.825] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
36
|
Freeman EW. Depression in the menopause transition: risks in the changing hormone milieu as observed in the general population. Womens Midlife Health 2015; 1:2. [PMID: 30766689 PMCID: PMC6214217 DOI: 10.1186/s40695-015-0002-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 06/18/2015] [Indexed: 01/05/2023] Open
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.
Collapse
Affiliation(s)
- Ellen W. Freeman
- Department of Obstetrics/Gynecology and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3701 Market Street, Suite 820 (Mudd Suite), Philadelphia, PA 19104 USA
| |
Collapse
|
37
|
Hui LY, Wang YW, Zhou FL, Ma XC, Yan RZ, Zhang L, Wang QL, Yu X. Association Between MKP-1, BDNF, and Gonadal Hormones with Depression on Perimenopausal Women. J Womens Health (Larchmt) 2015; 25:71-7. [PMID: 26176177 PMCID: PMC4741204 DOI: 10.1089/jwh.2015.5214] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Studies suggest that brain-derived neurotrophic factor (BDNF) exerts effects on the neuronal function of hippocampal neurons and increases hippocampal mitogen-activated protein kinase phosphatase-1 (MKP-1) expression, which causes depressive behaviors in rat or mouse. Here we focus on the change of serum MKP-1, BDNF, testosterone (T), and estradiol (E2) levels, in order to test the hypothesis that dysregulation of MKP-1, BDNF, T, and E2 are associated with depression in perimenopausal women. METHODS Women with depression, after meeting criteria in the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, for mental and behaviural disorders and the 17-item Hamilton Depression Rating Scale (HDRS), were included in the study. Psychosocial data and blood samples were obtained from the subjects in the study, including 38 perimenopausal and 32 young women with depression, 26 healthy control perimenopausal women, and 34 young women. RESULTS Serum MKP-1 levels were higher and T was lower in the women with depression compared to controls (p<0.05), and depressed perimenopausal women exhibited the highest serum MKP-1 levels and lowest T levels. Logistic regression analyses showed that MKP-1 levels were positively correlated with HDRS scores in the women, and T levels were inversely correlated with HDRS scores in the perimenopausal women (p<0.05). CONCLUSIONS This study suggests that high serum MKP-1 levels are associated with depression in women, and this association did not appear to be confounded by age. Further, the results provide evidence of association between depressive symptom severity and increasing serum MKP-1 levels in women, and decreasing T levels in perimenopausal women.
Collapse
Affiliation(s)
- Ling-yun Hui
- 1 First Affiliated Hospital, Xi'an Jiaotong University , Xi'an, Shaanxi, China
| | - Ya-wen Wang
- 1 First Affiliated Hospital, Xi'an Jiaotong University , Xi'an, Shaanxi, China
| | - Fu-ling Zhou
- 2 Second Affiliated Hospital, Xi'an Jiaotong University , Xi'an, Shaanxi, China
| | - Xian-cang Ma
- 1 First Affiliated Hospital, Xi'an Jiaotong University , Xi'an, Shaanxi, China
| | - Run-zhi Yan
- 1 First Affiliated Hospital, Xi'an Jiaotong University , Xi'an, Shaanxi, China
| | - Lin Zhang
- 1 First Affiliated Hospital, Xi'an Jiaotong University , Xi'an, Shaanxi, China
| | - Quan-li Wang
- 3 Medical College of Xi'an Jiaotong University , Xi'an, Shaanxi, China
| | - Xuewen Yu
- 1 First Affiliated Hospital, Xi'an Jiaotong University , Xi'an, Shaanxi, China
| |
Collapse
|
38
|
Müller B, Nienaber CA, Reis O, Kropp P, Meyer W. Sexuality and affection among elderly German men and women in long-term relationships: results of a prospective population-based study. PLoS One 2014; 9:e111404. [PMID: 25369193 PMCID: PMC4219747 DOI: 10.1371/journal.pone.0111404] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Accepted: 09/29/2014] [Indexed: 11/29/2022] Open
Abstract
Satisfaction with sexual activity i.e. sexual satisfaction and the importance of sexuality and affection were analysed using data from the German “Interdisciplinary Longitudinal Study of Adult Development” (ILSE). At three measurement points, 1993–1995, 1997–1998, and 2004–2006 i.e. subjects' ages of 63, 67, and 74 years, participants' reports about their affection and sexual activity were collected. The sample of completed records used for this study consisted of 194 urban non-institutionalised participants, 68% male, all living with partners. Median levels of sexual satisfaction were reported, fluctuating between the measurement points of ages 63 to 74. Between baseline, first and second follow-up no differences were found in levels of sexual satisfaction, though at measurement points age 63 and 67 women were more satisfied than men. When measured at age 74, affection was given a higher priority than sexual activity. Although men and women reported similar priorities, sexual activity and affection were more important for men than for women. Satisfaction within the relationship can be predicted by the importance of affection, but not by that of sexual activity. Our results confirm the thesis of the ‘second language of sexuality’: for humans in their later years affection seems to be more important than for younger individuals.
Collapse
Affiliation(s)
- Britta Müller
- Institute of Medical Psychology and Medical Sociology, Medical Faculty, University of Rostock, Rostock, Germany
- * E-mail:
| | - Christoph A. Nienaber
- Medical Center Rostock, Department of Cardiology and Angiology, Rostock University Hospital, University of Rostock, Rostock, Germany
| | - Olaf Reis
- Clinic for Child and Adolescent Psychiatry, Rostock University Hospital, University of Rostock, Rostock, Germany
| | - Peter Kropp
- Institute of Medical Psychology and Medical Sociology, Medical Faculty, University of Rostock, Rostock, Germany
| | - Wolfgang Meyer
- Queen Mary University of London, Barts and the London School of Medicine and Dentistry, London, United Kingdom
| |
Collapse
|
39
|
Luger TM, Suls J, Vander Weg MW. How robust is the association between smoking and depression in adults? A meta-analysis using linear mixed-effects models. Addict Behav 2014; 39:1418-29. [PMID: 24935795 DOI: 10.1016/j.addbeh.2014.05.011] [Citation(s) in RCA: 142] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Revised: 04/29/2014] [Accepted: 05/21/2014] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Our objective was to use meta-analytic techniques to assess the strength of the overall relationship and role of potential moderators in the association between smoking and depression in adults. METHODS Two popular health and social science databases (PubMed and PsycINFO) were systematically searched to identify studies which examined the association between adult smoking behavior and major depressive disorder (MDD) or depressive symptoms. A total of 85 relevant studies were selected for inclusion. Studies were analyzed using a linear mixed effects modeling package ("lme4" for R) and the Comprehensive Meta-Analysis program version 2. RESULTS Multiple nested linear mixed-effects models were compared. The best fitting models were those that included only random study effects and smoking status. In cross-sectional studies, current smokers were more likely to be depressed than never smokers (OR=1.50, CI=1.39-1.60), and current smokers were more likely to be depressed than former smokers (OR=1.76, CI=1.48-2.09). The few available prospective studies, that used the requisite statistical adjustments, also showed smokers at baseline had greater odds of incident depression at follow-up than never smokers (OR=1.62, CI=1.10-2.40). CONCLUSIONS In cross-sectional studies, smoking was associated with a nearly two-fold increased risk of depression relative to both never smokers and former smokers. In the smaller set of prospective studies, the odds of subsequent depression were also higher for current than never smokers. Attesting to its robustness, the relationship between smoking and depression was exhibited across several moderators. Findings could help health care providers to more effectively anticipate co-occurring health issues of their patients. Several methodological recommendations for future research are offered.
Collapse
|
40
|
Colvin A, Richardson GA, Cyranowski JM, Youk A, Bromberger JT. Does family history of depression predict major depression in midlife women? Study of Women's Health Across the Nation Mental Health Study (SWAN MHS). Arch Womens Ment Health 2014; 17:269-78. [PMID: 24952069 PMCID: PMC4120816 DOI: 10.1007/s00737-014-0433-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Accepted: 06/11/2014] [Indexed: 11/29/2022]
Abstract
This study aims to determine whether family history of depression predicts major depression in midlife women independent of psychosocial and health profiles at midlife. Participants were 303 African American and Caucasian women (42-52 years at baseline) recruited into the Study of Women's Health Across the Nation (SWAN) and the Women's Mental Health Study (MHS) in Pittsburgh. Major depression was assessed annually with the Structured Clinical Interview for DSM-IV. Family mental health history was collected at the ninth or tenth follow-up. Multivariable logistic regression was used to determine whether family history of depression predicted major depression in midlife, adjusting for covariates. The odds of experiencing major depression during the study were three times greater for those with a family history than for those without a family history (OR = 3.22, 95% CI = 1.95-5.31). Family history predicted depression (OR = 2.67, 95% CI = 1.50-4.78) after adjusting for lifetime history of depression, age, trait anxiety, chronic medical conditions, and stressful life events. In analyses stratified by lifetime history of depression, family history significantly predicted depression only among women with a lifetime history of depression. Family history of depression predicts major depression in midlife women generally, but particularly in those with a lifetime history of depression prior to midlife.
Collapse
Affiliation(s)
- Alicia Colvin
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 3811 O'Hara St., Pittsburgh, PA, 15213, USA
| | | | | | | | | |
Collapse
|
41
|
Worsley R, Bell R, Kulkarni J, Davis SR. The association between vasomotor symptoms and depression during perimenopause: A systematic review. Maturitas 2014; 77:111-7. [DOI: 10.1016/j.maturitas.2013.11.007] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Accepted: 11/24/2013] [Indexed: 01/22/2023]
|
42
|
Cultural/ethnic differences in the prevalence of depressive symptoms among middle-aged women in Israel. Menopause 2012; 19:1309-21. [DOI: 10.1097/gme.0b013e318258b1dd] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
|
43
|
Fooladi E, Bell RJ, Davis SR. Management strategies in SSRI-associated sexual dysfunction in women at midlife. Climacteric 2012; 15:306-16. [DOI: 10.3109/13697137.2012.658461] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
|
44
|
Yasui T, Matsui S, Tani A, Kunimi K, Yamamoto S, Irahara M. Androgen in postmenopausal women. THE JOURNAL OF MEDICAL INVESTIGATION 2012; 59:12-27. [DOI: 10.2152/jmi.59.12] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Toshiyuki Yasui
- Department of Reproductive Technology, Institute of Health Biosciences, the University of Tokushima Graduate School
| | - Sumika Matsui
- Department of Obstetrics and Gynecology, Institute of Health Biosciences, the University of Tokushima Graduate School
| | - Anna Tani
- Department of Obstetrics and Gynecology, Institute of Health Biosciences, the University of Tokushima Graduate School
| | - Kotaro Kunimi
- Department of Obstetrics and Gynecology, Institute of Health Biosciences, the University of Tokushima Graduate School
| | - Satoshi Yamamoto
- Department of Obstetrics and Gynecology, Institute of Health Biosciences, the University of Tokushima Graduate School
| | - Minoru Irahara
- Department of Obstetrics and Gynecology, Institute of Health Biosciences, the University of Tokushima Graduate School
| |
Collapse
|
45
|
Abstract
OBJECTIVE The aim of this study was to analyze the effect of participation in a mindfulness training program (mindfulness-based stress reduction, [MBSR]) on the degree of bother from hot flashes and night sweats. METHODS This study was a randomized trial of 110 late perimenopausal and early postmenopausal women experiencing an average of 5 or more moderate or severe hot flashes (including night sweats)/day. A wait-list control (WLC) was used with 3-month postintervention follow-up. The main outcome was the degree of bother from hot flashes and night sweats in the previous 24 hours. Secondary measures were hot flash intensity, quality of life, insomnia, anxiety, and perceived stress. RESULTS Baseline average (SD) hot flash frequency was 7.87 (3.44) and 2.81 (1.76) night sweats/day. Mean (SD) bothersomeness score was 3.18 (0.55; "moderately bothered/extremely bothered"). All analyses were intention to treat and were controlled for baseline values. Within-woman changes in bother from hot flashes differed significantly by treatment arm (week × treatment arm interaction, P = 0.042). At completion of the intervention, bother in the MBSR arm decreased on average by 14.77% versus 6.79% for WLC. At 20 weeks, total reduction in bother for MBSR was 21.62% and 10.50% for WLC. Baseline-adjusted changes in hot flash intensity did not differ between treatment arms (week × treatment arm interaction, P = 0.692). The MBSR arm made clinically significant improvements in quality of life (P = 0.022), subjective sleep quality (P = 0.009), anxiety (P = 0.005), and perceived stress (P = 0.001). Improvements were maintained 3 months postintervention. CONCLUSIONS Our data suggest that MBSR may be a clinically significant resource in reducing the degree of bother and distress women experience from hot flashes and night sweats.
Collapse
|
46
|
Pluchino N, Bucci F, Cela V, Cubeddu A, Genazzani AR. Menopause and Mental Well-Being: Timing of Symptoms and Timing of Hormone Treatment. WOMENS HEALTH 2011; 7:71-80. [DOI: 10.2217/whe.10.80] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
In the aftermath of the Women's Health Initiative studies, both the clinical and basic science communities had to sort out divergent results among experimental findings, observational data and randomized controlled trials in order to establish a shared analysis. The scientific community formally debates the role of different HRT formulations, hormone doses, time of treatment initiation since the menopause and the age of treated women. Basic scientists demonstrated that the multiple neuroprotective effects of estrogen on brain cells may induce a differential biological response according to the time of treatment. Progesterone (but not all synthetic progestins) also has pivotal neuroactive functions in animal models of reproductive aging. Additionally, epidemiological surveys provide information regarding the detrimental role of hypogonadism on mental well-being. The present article briefly summarizes current evidence supporting the neuroactive role of estrogen, with reference to the clinical finding sustaining the intriguing hypothesis of the early female brain senescence as a highly responsive period to estrogen treatment.
Collapse
Affiliation(s)
- Nicola Pluchino
- Department of Reproductive Medicine & Child Development, Division of Gynecology & Obstetrics, University of Pisa, Pisa, Italy
| | - Fiorella Bucci
- Department of Reproductive Medicine & Child Development, Division of Gynecology & Obstetrics, University of Pisa, Pisa, Italy
| | - Vito Cela
- Department of Reproductive Medicine & Child Development, Division of Gynecology & Obstetrics, University of Pisa, Pisa, Italy
| | - Alessandra Cubeddu
- Department of Reproductive Medicine & Child Development, Division of Gynecology & Obstetrics, University of Pisa, Pisa, Italy
| | - Andrea Riccardo Genazzani
- Department of Reproductive Medicine & Child Development, Division of Gynecology & Obstetrics, University of Pisa, Pisa, Italy
| |
Collapse
|
47
|
Abstract
OBJECTIVES The aims of this study were to identify the risk of depression in the transition to menopause in women with and without a history of depression and to consider that the changing hormonal milieu is one of multiple risk factors for perimenopausal depression. METHOD A review of epidemiologic studies of depressed mood in the menopausal transition since the State-of-Science Report of the National Institutes of Health in 2005 was conducted. RESULTS Recent longitudinal cohort studies indicate that the likelihood of depressed mood in the menopausal transition is approximately 30% to three times greater compared with that during premenopause. Women with a history of depression are nearly five times more likely to have a diagnosis of major depression in the menopausal transition, whereas women with no history of depression are two to four times more likely to report depressed mood compared with premenopausal women. In some studies, the changing hormonal milieu is significantly associated with depressive symptoms in the menopausal transition. Other risk factors for depressed mood in perimenopausal women include poor sleep, hot flashes, stressful or negative life events, employment status, age, and race. CONCLUSIONS The findings support the concept that the menopausal transition is a "window of vulnerability" for some women and is framed by the changing hormonal milieu of ovarian aging.
Collapse
Affiliation(s)
- Ellen W Freeman
- Department of Obstetrics/Gynecology, University of Pennsylvania, Philadelphia, PA, USA.
| |
Collapse
|
48
|
Al-Modallal H, Abuidhail J, Sowan A, Al-Rawashdeh A. Determinants of depressive symptoms in Jordanian working women. J Psychiatr Ment Health Nurs 2010; 17:569-76. [PMID: 20712679 DOI: 10.1111/j.1365-2850.2010.01562.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Depressive symptoms are an epidemic problem affecting different subgroups of women in clinical and non-clinical settings. However, depressive symptoms experienced by working women have rarely been studied. This study aimed at identifying depressive symptoms and their determinants in a sample of 101 Jordanian working women recruited from a higher educational institution. Data about women's depressive symptoms, their educational level, presence of children, sharing a job with an intimate partner, health status, diagnosis with chronic illnesses, and complaints of spousal abuse were collected. Logistic regression analysis was used to test for the significance of the selected factors on women's experiences of depressive symptoms. Findings indicated that 51.2% (n = 42) women complained of moderate and severe levels of depressive symptoms. Factors identified as significant in predicting depressive symptoms were women's experiences of spousal abuse (odds ratio adjusted = 3.5, 95% confidence interval = 1.05-11.7) and being diagnosed with chronic illnesses (odds ratio adjusted = 7.09, 95% confidence interval = 1.2-42.2). It was concluded that causes of women's depressive symptoms were imbedded in their familial and social environment, rather than their job per se. Mental health nurses can change the practice of nursing to better standards. Being familiarized with causes of depressive symptoms can empower nurses to be active advocates for depressed women.
Collapse
Affiliation(s)
- H Al-Modallal
- Assistant Professor, Hashemite University-Jordan, Zarqa, Jordan.
| | | | | | | |
Collapse
|
49
|
Romano-Torres M, Fernández-Guasti A. Estradiol valerate elicits antidepressant-like effects in middle-aged female rats under chronic mild stress. Behav Pharmacol 2010; 21:104-11. [PMID: 20168212 DOI: 10.1097/fbp.0b013e328337bdfc] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The purpose of this study was to analyze the antidepressant-like actions of estradiol valerate (1 or 2 mg/rat, single injection) or citalopram (5 or 10 mg/kg, chronically administered for 21 days) given independently or combined at low doses, to middle-aged ovariectomized female rats, as a model of human menopause. Animals were exposed to chronic mild stress, a model of depression that mimics anhedonia as revealed by diminished sucrose solution intake. Stressed rats decreased their sucrose preference 1 week after chronic stress and treatment with vehicle did not reverse this reduction. A single injection of estradiol valerate (2 mg/rat) produced an antidepressant-like action, evidenced as an increase in sucrose preference specific to stressed rats. Chronic citalopram (10 mg/kg) produced an antidepressant-like effect after 1 week. A single low-dose of estradiol valerate (1 mg/rat) did not potentiate or shorten the latency of action of chronic citalopram (5 mg/kg). These results reveal the antidepressant-like action of estrogens in middle-aged rats exposed to chronic stress. These data may be of importance for clinical depression in menopausal women.
Collapse
Affiliation(s)
- Mónica Romano-Torres
- Departamento de Farmacobiología, Centro de Investigación y de Estudios, Avanzados del IPN. Calzada de los Tenorios, Col. Granjas Coapa, Tlalpan, México City, México
| | | |
Collapse
|
50
|
Bromberger JT, Schott LL, Kravitz HM, Sowers M, Avis NE, Gold EB, Randolph JF, Matthews KA. Longitudinal change in reproductive hormones and depressive symptoms across the menopausal transition: results from the Study of Women's Health Across the Nation (SWAN). ARCHIVES OF GENERAL PSYCHIATRY 2010; 67:598-607. [PMID: 20530009 PMCID: PMC3129620 DOI: 10.1001/archgenpsychiatry.2010.55] [Citation(s) in RCA: 216] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CONTEXT The contribution of reproductive hormones to mood has been the focus of considerable research. Results from clinical and epidemiological studies have been inconsistent. It remains unclear whether alterations in serum hormone levels across the menopausal transition are linked to depressive symptoms. OBJECTIVES To evaluate the relationship between serum hormone levels and high depressive symptoms and whether hormone levels or their change might explain the association of menopausal status with depressive symptoms previously reported in a national sample of midlife women. DESIGN A longitudinal, community-based, multisite study of menopause. Data were collected at baseline and annually from December 1995 to January 2008 on a range of factors. Early follicular phase serum samples were assayed for levels of estradiol, follicle-stimulating hormone, testosterone, and dehydroepiandrosterone sulfate. SETTING Seven communities nationwide. PARTICIPANTS A community-based sample of 3302 multiethnic women, aged 42 to 52 years, still menstruating and not using exogenous reproductive hormones. Main Outcome Measure Depressive symptoms assessed with the Center for Epidemiological Studies Depression Scale (CES-D). The primary outcome was a CES-D score of 16 or higher. RESULTS In multivariable random-effects logistic regression models, log-transformed testosterone level was significantly positively associated with higher odds of a CES-D score of 16 or higher (odds ratio = 1.15; 95% confidence interval, 1.01-1.31) across 8 years, and a larger increase in log-transformed testosterone from baseline to each annual visit was significantly associated with increased odds of a CES-D score of 16 or higher (odds ratio = 1.23; 95% confidence interval, 1.04-1.45). Less education, being Hispanic, and vasomotor symptoms, stressful life events, and low social support at each visit were each independently associated with a CES-D score of 16 or higher. No other hormones were associated with a CES-D score of 16 or higher. Being perimenopausal or postmenopausal compared with being premenopausal remained significantly associated with a CES-D score of 16 or higher in all analyses. CONCLUSIONS Higher testosterone levels may contribute to higher depressive symptoms during the menopausal transition. This association is independent of menopausal status, which remains an independent predictor of higher depressive symptoms.
Collapse
|