Menopause and Mood: The Role of Estrogen in Midlife Depression and Beyond

Menopausal Status Impact on the Quality of Life in Kazakhstani Healthcare Workers: A Cross-sectional Study

BACKGROUND

Menopausal quality of life (MenQoL) is a common concern that primary healthcare workers often encounter. Menopause has a significant impact on women's health, but studies examining its effect on the MenQoL of menopausal healthcare employees have produced conflicting results.

OBJECTIVE

The aim of this study was to compare the quality of life related to menopausal status (pre-, peri-, or postmenopausal) in healthcare workers from various clinical settings in Kazakhstan.

DESIGN

This was a cross-sectional study.

PARTICIPANTS

In total, 222 menopausal healthcare workers (physicians, nurses/midwives, administrative staff, and cleaners) were enrolled from hospitals affiliated with the University Medical Center (UMC) in Kazakhstan.

MAIN MEASURES

The outcome variable was assessed using the Menopausal Quality of Life Questionnaire (MENQOL), which evaluates MenQoL across four domains of menopausal symptoms: physical, psychological, vasomotor, and sexual.

KEY RESULTS

The most frequently reported menopausal symptoms were physical ones, such as feeling tired or worn out (70.7%), followed by feeling a lack of energy (65.3%) and dry skin (64.1%). The postmenopause group had the highest mean MenQoL score in the vasomotor domain (mean 3.46 ± 1.84). There was a borderline statistical significance when comparing postmenopause and perimenopause groups in the physical domain. The pairwise comparison of mean sexual scores revealed that postmenopause women had the highest average score (3.3 ± 2.36) compared to both premenopause (mean 2.3 ± 1.82) and perimenopause (mean 2.22 ± 1.58) groups (p < 0.05).

CONCLUSIONS

Menopausal status has influence on the MenQoL of healthcare workers. The study findings could have important implications for policymakers as they provide insight into the factors influencing the quality of life of menopausal healthcare employees. Creating a more menopause-friendly work environment may not only enhance the well-being of healthcare personnel but also improve their overall job satisfaction and performance.

Role of estrogen in treatment of female depression

Depression is a neurological disorder that profoundly affects human physical and mental health, resulting in various changes in the central nervous system. Despite several prominent hypotheses, such as the monoaminergic theory, hypothalamic-pituitary-adrenal (HPA) axis theory, neuroinflammation, and neuroplasticity, the current understanding of depression's pathogenesis remains incomplete. Importantly, depression is a gender-dimorphic disorder, with women exhibiting higher incidence rates than men. Given estrogen's pivotal role in the menstrual cycle, it is reasonable to postulate that its fluctuating levels could contribute to the pathogenesis of depression. Estrogen acts by binding to a diversity of receptors, which are widely distributed in the central nervous system. An abundance of research has established that estrogen and its receptors play a crucial role in depression, spanning pathogenesis and treatment. In this comprehensive review, we provide an in-depth analysis of the fundamental role of estrogen and its receptors in depression, with a focus on neuroinflammation, neuroendocrinology, and neuroplasticity. Furthermore, we discuss potential mechanisms underlying the therapeutic effects of estrogen in the treatment of depression, which may pave the way for new antidepressant drug development and alternative treatment options.

Prevalence of depression among Iranian children and adolescents: An updated systematic review and meta-analysis

Background and Aims

One of the most common mental disorders among children and adolescent is depression. Some of the conducted studies indicate a too-high prevalence of depression, which cannot be generalized to the entire country. So the pooled estimation of the results of different studies is very important to reach valid results. So the current study aimed to determine the prevalence of depression among Iranian children and adolescents using an updated systematic review and meta-analysis.

Methods

A random-effects model was used to estimate the pooled prevalence of depression (I 2 = 99.7% and Cochran's Q, p < 0.001). To assess the effect of different factors on heterogeneity, the univariate meta-regression model was used. Publication bias was evaluated by Beggs and Eggers tests as well as funnel plots. Data were analyzed by STATA v 11 (StataCorp.). The significance level of the tests was considered less than 0.05.

Results

The prevalence of depression was 33.3% (95% CI: 27.3-39.2). The most prevalence estimated using the Beak questionnaire (57.1% [95% CI: 50.2-64.0]) and the lowest was estimated using the K-SADS-PL (9.0% [95% CI: 4.0-13.6]). This estimate among females was more than among males (47.2% [95% CI: 35.4-58.9] vs. 30.5 [95% CI: 7.4-53.6]). Regarding the geographical region, the most and the lowest amount of depression was seen in the central with 41.7% (95% CI: 19.2-64.3) and southern region with 21.9% (95% CI: 14.2-29.6), respectively.

Conclusion

The high prevalence of depressive disorders in Iranian children emphasizes the importance of prevention measures for these disorders.