Symptoms assessed in studies on perimenopausal depression: A narrative review

She said, "Really, you're just going to have to suffer through it": The lack of discussion of perimenopause between women and healthcare professionals

Perimenopausal symptoms adversely impacting women's sexual health are often unacknowledged or even dismissed by healthcare professionals (HCP). Using semi-structured interviews with 23 women experiencing perimenopause, we aimed to understand how HCPs address women's sexual health needs and concerns during this transition. Thematic data analysis was employed with the reduction of data into themes. Several major themes were identified concerning participants' experiences with a HCP and sexual health, including insufficient sexual health information and preventative education; the lack of open discussion about sexual health; the need for enhanced support and treatment options; feeling dismissed by a healthcare professional; and sexual pleasure not addressed by healthcare professionals. Additionally, women expressed concerns regarding medical education and training in healthcare professionals on approaching sexual health conversations. There appears to be a need for more formal training, both within medical school and continuing medical education (CME), to address these important aspects of women's sexual and reproductive health.

A clinical trial of the effects of cocoa rich chocolate on depression and sleep quality in menopausal women

In this triple-blind, randomized clinical trial, 60 menopausal women between the ages of 45 and 65 were randomized to receive 78% dark chocolate (12 g/day) or milk chocolate (12 g/day) for eight weeks. The primary outcome was depression scores. Secondary outcomes included sleep quality and anthropometric indices. ANCOVA with baseline adjustment showed that the mean depression score after the intervention in the group receiving dark chocolate was significantly reduced compared to the milk chocolate group (mean difference: -2.3; 95% confidence interval: -3.9 to -0.8; p = 0.003; Cohen's d = -0.54). However, no statistically significant difference in the overall sleep quality score and its subdomains was observed between the two groups after the intervention (p > 0.05). Furthermore, after the intervention, there was no statistically significant difference between the two groups in terms of anthropometric indices, including weight (p = 0.075), BMI (p = 0.137), waist circumference (p = 0.463), and hip circumference (p = 0.114). The study suggests that consuming 78% dark chocolate for eight weeks may contribute to improvements in depression scores, but it does not appear to improve sleep quality or anthropometric indices.Trial registration: IRCT20220926056046N1; December 2022.

Development and verification of the Menopause Emotional Symptom Questionnaire

OBJECTIVE

A detailed, well-validated scale for measuring emotional symptoms in menopausal women is lacking. We aimed to develop the Menopause Emotional Symptom Questionnaire (MESQ) and to confirm its reliability and validity among Koreans.

METHODS

Eighteen primary items based on previous research results were selected using exploratory factor analysis and confirmatory factor analysis (CFA). New data, including answers to the novel MESQ, Menopause Rating Scale, Kupperman Index, Beck Depression Inventory-II, and Beck Anxiety Inventory, were collected from 200 perimenopausal women and 100 young men through a research company. Exploratory factor analysis and CFA were performed again to determine whether the MESQ accurately measures emotional symptoms in perimenopausal women. Receiver operating characteristic curve and k-means cluster analyses were used to identify the most appropriate cutoff value.

RESULTS

The MESQ showed high internal consistency (Cronbach α = 0.926), and the CFA revealed that the factor structure comprised two subscales: nine items for mood/anxiety symptoms and four items for sleep symptoms. A high correlation between the total MESQ score and total scores of the existing scales was confirmed, indicating high convergence validity. Comparison of the mean MESQ scores between men and women showed significant sex difference, indicating secure known-group validity. The cutoff point of the total MESQ score between the high-risk and low-risk groups was 26.

CONCLUSIONS

The novel MESQ has high validity and reliability, and this study confirmed that the MESQ is a valid tool for screening for and measuring emotional symptoms in menopausal women in Korea.

Swedish women's experiences of menopausal transition: A focus group study

OBJECTIVE

The aim of this study was to examine women's experience of menopausal transition and their expectations and wishes for support from healthcare. Further, to examine their knowledge about menopause and thoughts about current attitudes in healthcare and in society generally.

METHODS

Data was collected through three focus group interviews with 14 women experiencing menopausal symptoms. The qualitative analysis was transacted through systematic text condensation, where categories were derived from data.

RESULTS

The women in this study told us about being inadequately prepared for menopause through having insufficient knowledge of the menopausal transition. They experienced lack of clarity about where in the health care system they could get help and that knowledge of menopause varied among healthcare staff. The attitudes to menopause experienced by women in this study were both positive and negative, but they often equated menopause with getting old. To be better prepared for the climacteric transition, the women wanted information from health care professionals and they wanted menopausal care to be easily accessible and local. If needed, it should be possible to access clinics providing specialist care.

CONCLUSION

This work indicates that women want more and improved information about menopause in order to be better prepared. Advice and treatment for menopausal healthcare care should be easily accessible for women. Improved education and care guidelines for menopausal problems can be helpful for healthcare staff.

Neuroprotective Effects of Estrogen Through BDNF-Transient Receptor Potential Channels 6 Signaling Pathway in the Hippocampus in a Rat Model of Perimenopausal Depression

Estradiol (E₂) has been proven to be effective in treating perimenopausal depression (PD); however, the downstream signaling pathways have not been fully elucidated. Transient receptor potential channels 6 (TRPC6) plays a vital role in promoting neuronal development and the formation of excitatory synapses. At present, we found that the serum levels of E₂ and brain-derived neurotrophic factor (BDNF) declined significantly in the women with PD compared to perimenopausal women, which was accompanied by a clear reduction in TRPC6 levels. To further reveal the effects of TRPC6 on neuronal survival and excitability, the PD-like rat model was established by the total removal of left ovary and 80% removal of right ovary followed by 21 days of the chronic unpredictable mild stress. Intragastric administration of E₂ (2 mg/kg), intraperitoneal injection of BDNF/TrB signaling pathway inhibitor (K252a, 100 μg/kg) and TRPC6 agonist (OAG, 0.6 mg/kg), and intracerebroventricular infusion of anti-BDNF antibody for blocking BDNF (0.5 μg/24 μl/rat) daily for 21 days were conducted. The levels of BDNF and TRPC6 in rat serum were lower in PD rats compared to the control rats; the depression-like behavior was induced, the neuronal death rate in the hippocampus increased, and the thickness of postsynaptic density (PSD) and the number of asymmetric synapses decreased significantly in the PD group. E₂ treatment greatly upregulated the serum levels of BDNF and TRPC6, the neuronal excitability indicated by an elevation in the PSD thickness and the numbers of asymmetric synapses, and these actions were reversed by K252a; co-administration of TRPC6 agonist and K252a improved neuronal degeneration and increased the neuronal excitability induced in the E₂-treated PD rats. K252a or anti-BDNF antibody inhibited the increased neuronal BDNF and TRPC6 expression in E₂-treated PD rats; co-treatment of TRPC6 agonist and anti-BDNF antibody reduced neuronal death and increased the BDNF and TRPC6 expression in the hippocampal CA1 neurons in the E₂-treated PD rats. These results suggest that the neuroprotective role of E₂ in PD is closely related to enhance the activity of BDNF/TRPC6 pathway and is helpful to provide new prevention and strategies.

Acupuncture combined with SSRIs in the treatment of perimenopausal depressive disorder: A protocol for systematic review and meta-analysis

BACKGROUND

Perimenopausal depressive disorder (PDD) is an affective disorder involving endocrine, neurological, immune, which seriously endangers the physical and mental health of human. Selective serotonin reuptake inhibitors (SSRIs) are the current first-line clinical treatment, have limited efficacy and serious side effects. Acupuncture combined with SSRIs therapy has been widely used clinically because it increases efficacy and reduces side effects. There is a lack of high-quality evidence to assess its efficacy and safety. This study evaluated the effectiveness and safety of acupuncture combined with SSRIs in the treatment of PDD by meta-analysis.

METHODS

All randomized controlled trials articles about acupuncture combined with SSRIs treatment of PDD will be searched in databases, such as PubMed, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wan Fang, Wei Pu from the construction of the library to December 16, 2021. According to Cochrane 5.1 Handbook criteria, two researchers independently screened the literature, extracted data, and evaluated the quality of included studies. Meta-analysis was performed by using RevMan 5.4 and STATA 16.0 software.

RESULTS

This study will summarize the current evidence to evaluate the effectiveness and safety of acupuncture combined with SSRIs for the treatment of PDD.

CONCLUSION

The results of this study will provide clinicians with new treatment ideas and bring benefits to most patients.

REGISTRATION NUMBER

INPLASY2021120080 (DOI number: 10.37766/inplasy2021.12.0080).