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Vaziri‐harami R, Kazemi SN, Vaziri‐harami S, Hazari V, Farokh P, Valadbeigi T. The prevalence of depression and anxiety in premenopausal and menopausal women: A cross-sectional study. Health Sci Rep 2024; 7:e2267. [PMID: 39044847 PMCID: PMC11263131 DOI: 10.1002/hsr2.2267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 05/29/2024] [Accepted: 07/16/2024] [Indexed: 07/25/2024] Open
Abstract
Background and Aims Targeted research on physiological and psychological changes during menopause is crucial. Most studies have prioritized the investigation of psychological disorders during menopause, with a limited comparison of mental health among women in the various stages surrounding menopause. This study aims to explore the difference in depression and anxiety prevalence between women in premenopausal and menopause. Methods This cross-sectional study was conducted on 242 female participants referred to Imam Hossein (AS) Educational and Therapeutic Hospital affiliated with Shahid Beheshti University of Medical Sciences. These 242 individuals were selected through accessible sampling. 122 individuals were placed in the menopausal group and 120 individuals in the premenopausal group. First, the medical history of all participants was taken, and then the Beck questionnaire was administered to examine the levels of depression and anxiety. The association between the occurrence and severity of depression and anxiety in menopausal and premenopausal groups was statistically analyzed. Results In this study, the age range of the participants was 45-70, the overall prevalence of depression was estimated to be 33.5% and the overall prevalence of anxiety was estimated to be 54.2%. The prevalence of depression was 30.2% and 36.6% in the menopausal and premenopausal groups, respectively. The prevalence of anxiety was estimated to be 52.5% and 55.7% in the menopausal and premenopausal groups, respectively. No significant difference was observed between the two groups in terms of the occurrence and severity of depression and anxiety. Conclusion our study found a higher incidence of depression during premenopause compared to menopause, possibly due to greater hormonal fluctuations. Despite this, there wasn't a significant confirmation of this hypothesis compared to other groups. Nonetheless, there's a higher prevalence of depression and anxiety among premenopausal women, emphasizing the need for screening and intervention, such as hormone therapy, to prevent severe outcomes.
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Affiliation(s)
- Roya Vaziri‐harami
- Department of Psychiatry, School of Medicine, Behavioral Sciences Research Center, Imam Hossein HospitalShahid Beheshti University of Medical SciencesTehranIran
| | - Seyyedeh Neda Kazemi
- Preventative Gynecology Research CenterShahid Beheshti University of Medical SciencesTehranIran
- Department of Obstetrics and GynecologyEndocrinology and Female Infertility Unit, Tehran University of Medical SciencesTehranIran
| | - Saharnaz Vaziri‐harami
- Department of PsychiatrySchool of Medicine, Behavioral Sciences Research Center, Shahid Beheshti University of Medical SciencesTehranIran
| | - Vajiheh Hazari
- Department of GynecologySchool of Medicine, Birjand University of Medical SciencesBirjandIran
| | - Parisa Farokh
- Student of Research CommitteeShahid Beheshti University of Medical SciencesTehranIran
| | - Tanaz Valadbeigi
- Department of Epidemiology and BiostatisticsSchool of Public Health, Tehran University of Medical SciencesTehranIran
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2
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Brown L, Hunter MS, Chen R, Crandall CJ, Gordon JL, Mishra GD, Rother V, Joffe H, Hickey M. Promoting good mental health over the menopause transition. Lancet 2024; 403:969-983. [PMID: 38458216 DOI: 10.1016/s0140-6736(23)02801-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/01/2023] [Accepted: 12/11/2023] [Indexed: 03/10/2024]
Abstract
The potential risk for mental health conditions over the menopause transition shapes women's expectations and informs putative physiological mechanisms regulating women's mental health. We review evidence from prospective studies reporting on associations between mental health conditions and the menopause transition. Major depressive disorder and the more prevalent subthreshold depressive symptoms are the most common conditions studied. We reviewed 12 prospective studies reporting depressive symptoms, major depressive disorder, or both over the menopause transition and found no compelling evidence for a universal increased risk for either condition. However, specific subgroups of participants, primarily defined by menopause-related risk factors (ie, vasomotor symptoms that are severe or disturb sleep, a long duration of the transition, or reproductive hormone dynamics) and psychosocial risk factors (eg, stressful life events), were vulnerable to depressive symptoms. The increased risk of major depressive disorder over the menopause transition appears predominantly in individuals with previous major depressive disorder. Greater focus on recognising risk factors in primary care is warranted. On the basis of scarce data, we found no compelling evidence that risk of anxiety, bipolar disorder, or psychosis is universally elevated over the menopause transition. Potential misattribution of psychological distress and psychiatric disorders to menopause could harm women by delaying accurate diagnosis and the initiation of effective psychotropic treatments, and by creating negative expectations for people approaching menopause. A paradigm shift is needed. We conclude with recommendations for the detection and treatment of depressive symptoms or major depressive disorder and strategies to promote good mental health over the menopause transition, while responsibly preparing and supporting those at risk.
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Affiliation(s)
- Lydia Brown
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia; Academic Research Collaborative in Health, La Trobe University, Bundoora, VIC, Australia; Healthscope Hospitals, Melbourne, VIC, Australia.
| | - Myra S Hunter
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Rong Chen
- Department of Obstetrics and Gynaecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
| | - Carolyn J Crandall
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA, USA
| | | | - Gita D Mishra
- NHMRC Centre for Research Excellence in Women and NCDs, School of Public Health, University of Queensland, Brisbane, QLD, Australia
| | - Viktoria Rother
- Inner West Area Mental Health Service, Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Hadine Joffe
- Connors Center for Women's Health and Gender Biology and Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Martha Hickey
- Department of Obstetrics, Gynaecology and Newborn Health, University of Melbourne and the Royal Women's Hospital, Melbourne, VIC, Australia
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3
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Abstract
Depression is a disabling condition that often leads to significant burden. Women are more vulnerable to depression during reproductive-related "windows of vulnerability" such as the menopause transition and early postmenopausal years. This heightened vulnerability can be attributed, at least in part, to the neuromodulatory effects of estrogen on mood and cognition and the exposure to rapid fluctuations of estradiol levels during midlife years. The management of midlife depression can be challenging due to the presence and severity of other complaints such as vasomotor symptoms and sleep disturbances. Psychopharmacologic, behavioral, and hormonal interventions should be part of the treatment armamentarium.
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Affiliation(s)
- Claudio N Soares
- Department of Psychiatry, Queen's University School of Medicine, Kingston, Ontario, Canada.
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Ozcan H, Savci H, Canik M, Ayan M, Bas CF. Comparison of the relationship between menopausal symptoms and loneliness and anger. Perspect Psychiatr Care 2022; 58:1900-1906. [PMID: 35037249 DOI: 10.1111/ppc.13004] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 07/18/2021] [Accepted: 12/09/2021] [Indexed: 11/28/2022] Open
Abstract
PURPOSE This study aimed to determine the relationship between the symptoms of anger and loneliness among women in the menopausal period. DESIGN AND METHODS A total of 200 women in the menopausal period were interviewed within the scope of this study. Descriptive Information Form, UCLA Loneliness Scale, Trait Anger and Anger Expression Scale and Menopause-Specific Quality of Life Questionnaire were used to collect data. FINDINGS The mean score of the UCLA Loneliness Scale was found as 53.61 ± 7.68 and it was observed that the participants had high traits of anger and a high-level of loneliness. Loneliness and anger increase when menopausal symptoms increase in women. PRACTICE IMPLICATIONS Menopause is generally perceived by women as a troublesome period instead of being a normal life process. In order for women to spend this period at a more comfortable and desirable level, it is important to know cultural characteristics, social support systems, coping mechanisms.
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Affiliation(s)
- Handan Ozcan
- Department of Midwifery, Faculty of Health Sciences, University of Health Sciences, Istanbul, Turkey
| | - Hamit Savci
- Department of Nursing, Faculty of Health Science, Gümüşhane University, Gümüşhane, Turkey
| | - Muhammed Canik
- Department of Nursing, Faculty of Health Science, Gümüşhane University, Gümüşhane, Turkey
| | - Mahsun Ayan
- Department of Nursing, Faculty of Health Science, Gümüşhane University, Gümüşhane, Turkey
| | - Cağla Firdevs Bas
- Department of Nursing, Faculty of Health Science, Gümüşhane University, Gümüşhane, Turkey
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5
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Metcalf CA, Johnson RL, Novick AM, Freeman EW, Sammel MD, Anthony LG, Epperson CN. Adverse childhood experiences interact with inflammation and menopause transition stage to predict verbal memory in women. Brain Behav Immun Health 2022; 20:100411. [PMID: 35079709 PMCID: PMC8777090 DOI: 10.1016/j.bbih.2022.100411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 01/03/2022] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE Women with more adverse childhood experiences (ACEs) may face a triple threat of risk factors for cognitive concerns during the menopause transition: reduced estradiol, increased inflammation, and early life stress sequelae. Our objective was to determine the extent to which ACEs and peripheral basal inflammatory markers associate with verbal memory across the menopause transition. METHODS Penn Ovarian Aging cohort participants (n = 167) were assessed for ACEs (low (0-1) or high (≥2)) and had remaining stored blood samples at study end assayed for interleukin (IL)-6, IL-1-beta (IL-1β), C-reactive protein (CRP), and tumor necrosis factor alpha (TNF-α). Annual assessment included a verbal memory test (the Buschke Selective Reminding Test) and menopause stage determination. To estimate the effects of menopause stage, ACEs, and cytokines on verbal memory, repeated cognitive outcome measures were modeled in generalized estimating equations. Covariates included body mass index, smoking, race, education, age at baseline, and baseline verbal memory performance. Cytokine levels were log-transformed. RESULTS Advancing menopause stage was associated with worse performance on immediate verbal recall and delayed verbal recall (ps < 0.001). During perimenopause, higher ACE exposure was associated with worse immediate verbal recall at higher levels of TNF-α (slope difference p = 0.041). CONCLUSIONS Inflammation may mechanistically link ACEs and verbal memory for high ACE women during perimenopause. Reducing inflammation for these individuals may have positive impact on verbal memory across the menopause transition.
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Affiliation(s)
- Christina A. Metcalf
- Department of Psychiatry, University of Colorado-Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Rachel L. Johnson
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Andrew M. Novick
- Department of Psychiatry, University of Colorado-Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Ellen W. Freeman
- Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Mary D. Sammel
- Department of Psychiatry, University of Colorado-Anschutz Medical Campus, Aurora, CO, 80045, USA
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Laura G. Anthony
- Department of Psychiatry, University of Colorado-Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - C. Neill Epperson
- Department of Psychiatry, University of Colorado-Anschutz Medical Campus, Aurora, CO, 80045, USA
- Department of Family Medicine, University of Colorado-Anschutz Medical Campus, Aurora, CO, 80045, USA
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Shinjyo N, Waddell G, Green J. Valerian Root in Treating Sleep Problems and Associated Disorders-A Systematic Review and Meta-Analysis. J Evid Based Integr Med 2021; 25:2515690X20967323. [PMID: 33086877 PMCID: PMC7585905 DOI: 10.1177/2515690x20967323] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Sleep problems are widely prevalent and associated with various comorbidities including anxiety. Valerian (Valeriana officinalis L.) is a popular herbal medicine used as a sleep aid, however the outcomes of previous clinical studies are inconsistent. This study was conducted to update and re-evaluate the available data in order to understand the reason behind the inconsistent outcomes and to provide a broader view of the use of valerian for associated disorders. PubMed, ScienceDirect, and Cochrane Library were searched to retrieve publications relevant to the effectiveness of valerian as a treatment of sleep problems and associated disorders. A total of 60 studies (n=6,894) were included in this review, and meta-analyses were performed to evaluate the effectiveness to improve subjective sleep quality (10 studies, n=1,065) and to reduce anxiety (8 studies, n=535). Results suggested that inconsistent outcomes were possibly due to the variable quality of herbal extracts and that more reliable effects could be expected from the whole root/rhizome. In addition, therapeutic benefits could be optimized when it was combined with appropriate herbal partners. There were no severe adverse events associated with valerian intake in subjects aged between 7 and 80 years. In conclusion, valerian could be a safe and effective herb to promote sleep and prevent associated disorders. However, due to the presence of multiple active constituents and relatively unstable nature of some of the active constituents, it may be necessary to revise the quality control processes, including standardization methods and shelf life.
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Affiliation(s)
- Noriko Shinjyo
- Department of Infection and Host Defence, Graduate School of Medicine, 12737Chiba University, Chuo-ku, Chiba, Japan.,School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | | | - Julia Green
- Faculty of Science and Technology, Department of Life Sciences, 4921University of Westminster, London, UK
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Effect of Hypnosis on Anxiety: Results from a Randomized Controlled Trial with Women in Postmenopause. J Clin Psychol Med Settings 2021; 28:868-881. [PMID: 34403019 DOI: 10.1007/s10880-021-09810-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2021] [Indexed: 01/27/2023]
Abstract
Anxiety is common, yet often under-treated, among women in postmenopause. This study examined the effect of a hypnotic intervention designed to reduce hot flashes, on anxiety levels of postmenopausal women. Anxiety was assessed using the State-Trait Anxiety Inventory, the Hospital Anxiety and Depression Scale-Anxiety subscale, and a visual analog scale. Additionally, hypnotizability was tested as a moderator of anxiety reductions. Significant reductions in anxiety were found from baseline to endpoint and follow-up and hypnosis was superior to the control condition. Additionally, ratings of Current Anxiety decreased from pre-session to post-session at each weekly visit and the pre-session scores reduced continuously. Hypnotizability was found to moderate anxiety reductions, but regardless of hypnotizability level participants, on average, experienced significant symptom improvement from baseline scores. These data provide initial support for the use of hypnosis to reduce symptoms of anxiety among postmenopausal women.Trial registration: This study was registered at ClinicalTrials.gov on February 11, 2011 under Identifier number NCT01293695 ( https://clinicaltrials.gov/ct2/show/NCT01293695?term=Elkins&cond=hot+flashes&draw=2&rank=2 ).
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8
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Soares CN, Shea AK. The Midlife Transition, Depression, and Its Clinical Management. Obstet Gynecol Clin North Am 2021; 48:215-229. [PMID: 33573787 DOI: 10.1016/j.ogc.2020.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The World Health Organization estimates that more than 260 million people are affected by depression worldwide, a condition that imposes a significant burden to individuals, their families, and society. Women seem to be disproportionately more affected by depression than men, and it is now clear that some women may experience windows of vulnerability for depression at certain reproductive stages across their life span, including the midlife transition. For some, age, the presence of cardiovascular or metabolic problems, and the emergence of significant, bothersome vasomotor symptoms and sleep problems may result in a compounded, deleterious impact on well-being and overall functioning.
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Affiliation(s)
- Claudio N Soares
- Department of Psychiatry, Queen's University School of Medicine, Providence Care Hospital, 752 King Street West, Kingston, Ontario K7L 4X3, Canada.
| | - Alison K Shea
- Department of Obstetrics and Gynecology, Faculty of Health Sciences, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4L8, Canada
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9
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Reame NK. Anxiety and hot flashes as predictors of mid-life palpitations: getting to the heart of the matter in the time of COVID-19. Menopause 2021; 28:731-734. [PMID: 34165445 PMCID: PMC8240496 DOI: 10.1097/gme.0000000000001808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 04/27/2021] [Accepted: 04/27/2021] [Indexed: 11/26/2022]
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10
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Jaeger MDB, Miná CS, Alves S, Schuh GJ, Wender MC, Manfro GG. Negative affect symptoms, anxiety sensitivity, and vasomotor symptoms during perimenopause. REVISTA BRASILEIRA DE PSIQUIATRIA (SAO PAULO, BRAZIL : 1999) 2021; 43:277-284. [PMID: 33053044 PMCID: PMC8136388 DOI: 10.1590/1516-4446-2020-0871] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 06/20/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Vasomotor symptoms affect 60-80% of women during the menopausal transition. Anxiety, depression, and anxiety sensitivity can have an important role in the distressful experience of vasomotor symptoms. Our aim was to evaluate the prevalence and association of vasomotor and negative affect symptoms. METHODS A cross-sectional study was conducted with 89 perimenopausal women aged 45-55 years. Broad psychiatric and clinical evaluations were carried out. The primary outcome was the vasomotor symptom problem rating and the main study factor was anxiety sensitivity. Linear regression analyses were conducted to examine the associations between the study factors and the primary outcome, and a multiple regression model was created to assess which variables were independently associated with vasomotor symptom problem rating. RESULTS The prevalence of anxiety, depression, and vasomotor symptoms were 58, 62, and 73%, respectively. Negative affect symptoms were positively associated with vasomotor symptom problem rating. The association of anxiety sensitivity and vasomotor symptom problem rating remained significant after controlling for perimenopausal stage, thyrotropin, follicle-stimulating hormone levels, and psychotropic medication use (β = 0.314, p = 0.002). CONCLUSION A better understanding of the experience of vasomotor symptoms is needed, especially the role of negative affect symptoms and anxiety sensitivity. New strategies focusing on related thoughts and behaviors could improve the quality of life of perimenopausal women.
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Affiliation(s)
- Marianna de B. Jaeger
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Camila S. Miná
- Programa de Pós-Graduação em Neurociências, Instituto de Ciências Básicas da Saúde (ICBS), UFRGS, Porto Alegre, RS, Brazil
| | - Sofia Alves
- Faculdade de Medicina, UFRGS, Porto Alegre, RS, Brazil
| | | | - Maria C. Wender
- Programa de Pós-Graduação em Ciências da Saúde: Ginecologia e Obstetrícia, UFRGS, Porto Alegre, RS, Brazil
| | - Gisele G. Manfro
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
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Dotlic J, Radovanovic S, Rancic B, Milosevic B, Nicevic S, Kurtagic I, Markovic N, Gazibara T. Mental health aspect of quality of life in the menopausal transition. J Psychosom Obstet Gynaecol 2021; 42:40-49. [PMID: 32131666 DOI: 10.1080/0167482x.2020.1734789] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE To evaluate factors associated with mental health quality of life (QOL), such as depressed mood, anxiety, poor memory and sleep, among midlife women according to the menopausal status. MATERIAL AND METHODS Participants were 500 women aged 40-65 years. Data were collected using socio-demographic questionnaire, Women's Health Questionnaire (domains of depressed mood-DEP, anxiety-ANX, memory-MEM and sleep-SLE) and Short Form-36 (Mental Composite Score) for assessment of health-related QOL. Factors associated with poorer DEP, ANX, MEM and SLE were examined using adjusted linear regression models. RESULTS In premenopausal women, lower household monthly income (p = .046) was associated with higher level of DEP; higher body mass index (p = .045) was associated with higher ANX; having gynecological illnesses (p = .017) and menopause-related symptoms (p = .039) were associated with poorer MEM; being married (p = .036), drinking alcohol (p = .036) and having more physical activity (p = .041) was associated with better SLE. In postmenopausal women, worse DEP was more likely among women residing in city outskirts (p = .009), who are not married (p = .038) and with sedentary occupations (p = .049); lower education level (p = .030) was associated with more ANX; lower education level (p = .045) and having menopause-related symptoms (p = .044) were associated with poorer MEM; not engaging in regular recreation (p = .031) was associated with better SLE. CONCLUSIONS To improve QOL, pre- and postmenopausal women should not only be supported in the management of menopause-specific symptoms. Women should also receive recommendations as to the behavioral and personal changes when approaching the midlife period.
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Affiliation(s)
- Jelena Dotlic
- Clinic for Obstetrics and Gynecology, Clinical Center of Serbia, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Biljana Rancic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Branislav Milosevic
- Clinic for Obstetrics and Gynecology, Clinical Center of Serbia, Belgrade, Serbia
| | - Selmina Nicevic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ilma Kurtagic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Tatjana Gazibara
- Institute for Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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12
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Tang R, Luo M, Li J, Peng Y, Wang Y, Liu B, Liu G, Wang Y, Lin S, Chen R. Relationships Between Vasomotor Symptoms and Mood in Midlife Urban Chinese Women: Observations in a Prospective Study. J Clin Endocrinol Metab 2020; 105:5897029. [PMID: 32841324 DOI: 10.1210/clinem/dgaa554] [Citation(s) in RCA: 8] [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: 05/12/2020] [Accepted: 08/20/2020] [Indexed: 11/19/2022]
Abstract
CONTEXT During the menopausal transition, there is a greater likelihood of the prevalence of various bothersome symptoms, including vasomotor symptoms (VMS) and mood symptoms. OBJECTIVE To investigate the association among bothersome VMS and symptoms of anxiety and depression in Chinese women during perimenopause and early in menopause. DESIGN, PATIENTS, SETTING, AND INTERVENTIONS This study included 430 midlife Chinese women who had experienced natural menopause and were followed up for 10 years. A structured questionnaire was provided annually, comprising the VMS Bother Score (range 1-8) from the Menopause-Specific Quality of Life questionnaire, the Hospital Anxiety and Depression Scale, and other physical and behavioral factors. RESULTS Among the 430 women evaluated, 78.8% had experienced VMS during long-term follow-up. The overall level of VMS bother score was relatively low (1.92 ± 1.32). Both anxiety and depressive symptoms were significantly associated with VMS bother. After adjusting for potential covariates, the association between anxiety or depression symptoms and VMS bother remained highly significant. Menopausal stage, body mass index, general health, follicle-stimulating hormone, and estradiol were independent contributors to VMS. In time-lagged (1-year) models, VMS bother scores significantly predicted the risk of symptoms of both anxiety and depression the following year. In contrast, anxiety symptoms, rather than depressive symptoms, could predict VMS bother the following year. CONCLUSION The prevalence of VMS in our cohort was higher than has been previously reported; however, the overall level of bother was relatively low. This study demonstrated a strong relationship between VMS bother and mood symptoms in Chinese women progressing from perimenopause through natural menopause.
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Affiliation(s)
- Ruiyi Tang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, People's Republic of China
| | - Min Luo
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, People's Republic of China
| | - Jiayi Li
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, People's Republic of China
| | - Yajing Peng
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, People's Republic of China
| | - Yuchen Wang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, People's Republic of China
| | - Bing Liu
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, People's Republic of China
| | - Gaifen Liu
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, People's Republic of China
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Yaping Wang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, People's Republic of China
| | - Shouqing Lin
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, People's Republic of China
| | - Rong Chen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, People's Republic of China
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13
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Chen R, Tang R, Zhang S, Wang Y, Wang R, Ouyang Y, Xie X, Liu H, Lv S, Shi H, Zhang Y, Xie M, Luo Y, Yu Q. Xiangshao granules can relieve emotional symptoms in menopausal women: a randomized controlled trial. Climacteric 2020; 24:246-252. [PMID: 33016149 DOI: 10.1080/13697137.2020.1820476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This study aimed to investigate the safety and efficacy of Xiangshao granules for treating emotional disorders in perimenopausal and postmenopausal women. METHODS The current investigation was a double-blind, randomized, placebo-controlled, multicenter trial that included 300 perimenopausal and postmenopausal Chinese women aged 40-60 years. Participants received either a placebo (n = 150) or Xiangshao granules (n = 150) for 8 weeks. Outcome measures included Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety Rating Scale (HAMA) scores, which were assessed at baseline, 4 weeks, and 8 weeks. The primary efficacy variables were changes in HAMD and HAMA scores after 8 weeks. RESULTS After 8 weeks, the mean HAMD scores decreased from 15.0 to 7.9 in the Xiangshao group and from 16.3 to 10.0 in the placebo group, and the respective mean reductions in HAMA scores were from 16.0 to 8.5 and from 17.1 to 10.9. Clinical improvements in symptoms of both depression and anxiety after 8 weeks differed significantly in the two groups (p < 0.05). The cure rate was significantly higher in the Xiangshao group. There were no significant differences in the rates of adverse events in the two groups. CONCLUSIONS Xiangshao granules can relieve symptoms of depression and anxiety significantly and safely.
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Affiliation(s)
- R Chen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
| | - R Tang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
| | - S Zhang
- Department of Obstetrics and Gynecology, Obstetrics & Gynecology Hospital of Fudan University, Shanghai, China
| | - Y Wang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
| | - R Wang
- Department of Obstetrics and Gynecology, Langfang Hospital of Traditional Chinese Medicine, Langfang, China
| | - Y Ouyang
- Department of Obstetrics and Gynecology, West China Second University Hospital, Chengdu, China
| | - X Xie
- Department of Obstetrics and Gynecology, 2nd Affliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - H Liu
- Department of Obstetrics and Gynecology, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China
| | - S Lv
- Department of Obstetrics and Gynecology, First-Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - H Shi
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Y Zhang
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, China
| | - M Xie
- Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Y Luo
- Department of Obstetrics and Gynecology, Chongqing University Affiliated Three Gorges Hospital, Chongqing, China
| | - Q Yu
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
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15
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Neutzling AL, Leite HM, Paniz VMV, de Bairros FS, Dias da Costa JS, Olinto MTA. Association between common mental disorders, sleep quality, and menopausal symptoms: a population-based study in Southern Brazil. ACTA ACUST UNITED AC 2020; 27:463-472. [DOI: 10.1097/gme.0000000000001524] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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16
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Zhang L, Huang Y, Ling J, Xiang Y, Zhuo W. Screening of key genes and prediction of therapeutic agents in Arsenic-induced lung carcinoma. Cancer Biomark 2020; 25:351-360. [PMID: 31322542 DOI: 10.3233/cbm-182333] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Evidence indicates that inorganic arsenic (iAs) can directly damage cells and result in malignant transformation with unclear complicated mechanisms. In the present study, we aimed to explore the possible molecules, pathways and therapeutic agents by using bioinformatics methods. METHODS Microarray-based data were retrieved and analyzed to screen the differentially expressed genes (DEGs) between iAs-treated lung cells and controls. Then, the functions of DEGs were annotated and the hub genes were filtrated. The key genes were selected from the hub genes through validation in The Cancer Genome Atlas (TCGA) cohorts. Possible drugs were predicted by using CMAP tool. RESULTS Two datasets (GSE33520 and GSE36684) were retrieved, and 61 up-regulated and 228 down-regulated DEGs were screened out, which were enriched in various pathways, particularly metabolism-related pathways. Among the DEGs, four hub genes including MTIF2, ACOX1, CAV1, and MRPL17, which might affect lung cancer prognosis, were selected as the key genes. Interestingly, Quinostatin was predicted to be a potential agent reversing iAs-induced lung cell malignant transformation. CONCLUSION The present study sheds novel insights into the mechanisms of iAs-induced lung cell malignant transformation and identified several potential small agents for iAs toxicity prevention and therapy.
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Affiliation(s)
- Liang Zhang
- Institute of Cancer, Xinqiao Hospital, Third Military Medical University (Army Medical University), Chongqing, China.,Department of Oncology, Chongqing Institute of Traditional Chinese Medicine, Chongqing, China
| | - Yu Huang
- Department of Invasive Technology, Cancer Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Junjun Ling
- Institute of Cancer, Xinqiao Hospital, Third Military Medical University (Army Medical University), Chongqing, China.,Department of Oncology, Chongqing Institute of Traditional Chinese Medicine, Chongqing, China
| | - Ying Xiang
- Department of Epidemiology, College of Preventive Medicine, Third Military Medical University (Army Medical University), Chongqing, China
| | - Wenlei Zhuo
- Institute of Cancer, Xinqiao Hospital, Third Military Medical University (Army Medical University), Chongqing, China.,Cancer Immunology Nutrition Group, Cancer Nutrition Professional Committee, China Anti-Cancer Association, China
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17
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Costanian C, Zangiabadi S, Bahous SA, Deonandan R, Tamim H. Reviewing the evidence on vasomotor symptoms: the role of traditional and non-traditional factors. Climacteric 2020; 23:213-223. [DOI: 10.1080/13697137.2019.1711051] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- C. Costanian
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- School of Medicine, Lebanese American University, Byblos, Lebanon
| | - S. Zangiabadi
- School of Kinesiology & Health Science, York University, Toronto, ON, Canada
| | - S. A. Bahous
- School of Medicine, Lebanese American University, Byblos, Lebanon
| | - R. Deonandan
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - H. Tamim
- School of Kinesiology & Health Science, York University, Toronto, ON, Canada
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Liu W, Qdaisat A, Lopez G, Narayanan S, Underwood S, Spano M, Reddy A, Guo Y, Zhou S, Yeung SC, Bruera E, Garcia MK, Cohen L. Acupuncture for Hot Flashes in Cancer Patients: Clinical Characteristics and Traditional Chinese Medicine Diagnosis as Predictors of Treatment Response. Integr Cancer Ther 2019; 18:1534735419848494. [PMID: 31046489 PMCID: PMC6501481 DOI: 10.1177/1534735419848494] [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: 12/12/2022] Open
Abstract
Background: Acupuncture is a recognized integrative modality for managing hot flashes. However, data regarding predictors for response to acupuncture in cancer patients experiencing hot flashes are limited. We explored associations between patient characteristics, including traditional Chinese medicine (TCM) diagnosis, and treatment response among cancer patients who received acupuncture for management of hot flashes. Methods: We reviewed acupuncture records of cancer outpatients with the primary reason for referral listed as hot flashes who were treated from March 2016 to April 2018. Treatment response was assessed using the hot flashes score within a modified Edmonton Symptom Assessment Scale (0-10 scale) administered immediately before and after each acupuncture treatment. Correlations between TCM diagnosis, individual patient characteristics, and treatment response were analyzed. Results: The final analysis included 558 acupuncture records (151 patients). The majority of patients were female (90%), and 66% had breast cancer. The median treatment response was a 25% reduction in the hot flashes score. The most frequent TCM diagnosis was qi stagnation (80%) followed by blood stagnation (57%). Older age (P = .018), patient self-reported anxiety level (P = .056), and presence of damp accumulation in TCM diagnosis (P = .047) were correlated with greater hot flashes score reduction. Conclusions: TCM diagnosis and other patient characteristics were predictors of treatment response to acupuncture for hot flashes in cancer patients. Future research is needed to further explore predictors that could help tailor acupuncture treatments for these patients.
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Affiliation(s)
- Wenli Liu
- 1 University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Aiham Qdaisat
- 1 University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Gabriel Lopez
- 1 University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Susan Underwood
- 1 University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michael Spano
- 1 University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Akhila Reddy
- 1 University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ying Guo
- 1 University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Shouhao Zhou
- 2 Pennsylvania State University, Hershey, PA, USA
| | - Sai-Ching Yeung
- 1 University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Eduardo Bruera
- 1 University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - M Kay Garcia
- 1 University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lorenzo Cohen
- 1 University of Texas MD Anderson Cancer Center, Houston, TX, USA
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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]
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20
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Ataei-Almanghadim K, Farshbaf-Khalili A, Ostadrahimi AR, Shaseb E, Mirghafourvand M. The effect of oral capsule of curcumin and vitamin E on the hot flashes and anxiety in postmenopausal women: A triple blind randomised controlled trial. Complement Ther Med 2019; 48:102267. [PMID: 31987231 DOI: 10.1016/j.ctim.2019.102267] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 11/24/2019] [Accepted: 11/25/2019] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE The decline and eventual cessation of estrogen production cause a variety of symptoms during menopause, affecting each woman differently. Most women reported severe hot flashes and night sweats during menopause. The present study aimed to determine and compare the efficacy of curcumin and vitamin E on hot flashes and anxiety (primary objectives), sexual function, menopausal symptoms and adverse effects (secondary objectives). MATERIALS AND METHODS This was a triple-blind randomized controlled clinical trial. The participants consisted of 93 postmenopausal women in Ahar city-Iran. They were assigned into three groups (two intervention groups and one control group). The first intervention group received oral capsule of curcumin (500 mg), the second intervention group was given oral tablets of vitamin E (200 IU/day), and the third group (control) received placebo twice a day for eight weeks. The participants completed the hot flash checklist one week before the intervention, and 4 weeks and 8 weeks after the intervention. They also filled out the Anxiety Scale, the Female Sexual Function Index (FSFI), the Greene Climacteric Scale before the intervention, and 4 weeks and 8 weeks after the intervention. One-way ANOVA, repeated measures ANOVA and ANCOVA tests were used for data analysis. RESULTS There was no statistically significant difference between groups in terms of demographic characteristics, mean number of hot flashes, mean score of anxiety, sexual function index and menopausal symptoms before the intervention (p > 0.05). The mean age of participants was 51.7 years. Mean number of hot flashes in the curcumin group (adjusted mean difference = -10.7, 95%confidence interval = -3.6 to -17.9, P = 0.001) and in the vitamin E group (-8.7, -0.6 to -15.0, P = 0.029) was significantly lower than the placebo group after the intervention. The first significant effect of curcumin on hot flashes was observed after four weeks (P = 0.027). However, there was no significant difference between vitamin E group and placebo four weeks after intervention (P = 0.052) and the first significant effect of vitamin E on hot flashes was observed after eight weeks (P = 0.025). There was no statistically significant difference between the groups in terms of sexual function index, anxiety and menopausal symptoms (P > 0.05). CONCLUSION The results of this study showed that oral intake of curcumin and vitamin E significantly reduced hot flashes in postmenopausal women but had no significant effect on anxiety, sexual function and menopausal symptoms.
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Affiliation(s)
| | - Azizeh Farshbaf-Khalili
- Physical Medicine and Rehabilitation Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Iran
| | | | - Elnaz Shaseb
- Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
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Cardiovascular reactivity and psychological hyperarousal in hot flash-associated insomnia disorder. Menopause 2019; 26:728-740. [DOI: 10.1097/gme.0000000000001298] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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22
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Soares CN. Depression and Menopause: An Update on Current Knowledge and Clinical Management for this Critical Window. Med Clin North Am 2019; 103:651-667. [PMID: 31078198 DOI: 10.1016/j.mcna.2019.03.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Windows of vulnerability for depression have been associated with increased sensitivity to hormonal changes experienced by some women during the luteal phase, postpartum, and/or menopause. Increased awareness has resulted in greater adoption of screening tools for mood and behavioral changes and tailored therapies. This article discusses study results and controversies surrounding therapies uniquely designed for menopause-related depression.
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Affiliation(s)
- Claudio N Soares
- Department of Psychiatry, Queen's University School of Medicine, 752 King Street West, Kingston, Ontario K7L 4X3, Canada; Research and Innovation, Providence Care Hospital, Kingston, Ontario, Canada.
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Hot flashes: treating the mind, body and soul. Menopause 2019; 26:461-462. [DOI: 10.1097/gme.0000000000001314] [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]
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Self-awareness and the evaluation of hot flash severity: observations from the Seattle Midlife Women's Health Study. Menopause 2018; 26:476-484. [PMID: 30531442 DOI: 10.1097/gme.0000000000001272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The purpose of this study was to test the association of two dimensions of self-awareness with hot flash (HF) severity. METHODS A subset of women from the Seattle Midlife Women's Health Study (N = 232) provided data for these analyses. Structural equation modeling was used to evaluate two dimensions of self-awareness (Internal States Awareness [ISA] and Self-Reflectiveness [SR]), and secondary factors of perceived stress, anxiety, and attitudes toward menopause as continuous with earlier life, health perceptions, and menopausal stage with respect to HF severity. The measurement and structural models were tested with a maximum likelihood missing values estimator and displayed good model fit. RESULTS Women with greater ISA reported greater HF severity (β = 0.17, P < 0.05). In addition, women in later menopausal transition stages reported greater HF severity and those with attitudes of continuity toward menopause reported less severe HFs (β = 0.20, P < 0.01, β = -0.30, P < 0.001, respectively). SR was not related to HF severity. Women with higher levels of SR reported greater perceived stress levels (β = .51, P < 0.001), and those with greater perceived stress reported greater anxiety levels (β = 0.63, P < 0.001) and attitudes of continuity toward menopause as less continuous with earlier life (β = -0.30, P < 0.001). CONCLUSIONS ISA (balanced self-awareness) was associated with greater HF severity, suggesting that enhanced balanced self-awareness may promote women's ability to evaluate their symptom experience. A multidimensional construct of self-awareness, perceived stress, anxiety, and attitude toward menopause are all plausible targets for future intervention studies of symptom management.
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Chung HF, Pandeya N, Dobson AJ, Kuh D, Brunner EJ, Crawford SL, Avis NE, Gold EB, Mitchell ES, Woods NF, Bromberger JT, Thurston RC, Joffe H, Yoshizawa T, Anderson D, Mishra GD. The role of sleep difficulties in the vasomotor menopausal symptoms and depressed mood relationships: an international pooled analysis of eight studies in the InterLACE consortium. Psychol Med 2018; 48:2550-2561. [PMID: 29429422 PMCID: PMC6087679 DOI: 10.1017/s0033291718000168] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Many women experience both vasomotor menopausal symptoms (VMS) and depressed mood at midlife, but little is known regarding the prospective bi-directional relationships between VMS and depressed mood and the role of sleep difficulties in both directions. METHODS A pooled analysis was conducted using data from 21 312 women (median: 50 years, interquartile range 49-51) in eight studies from the InterLACE consortium. The degree of VMS, sleep difficulties, and depressed mood was self-reported and categorised as never, rarely, sometimes, and often (if reporting frequency) or never, mild, moderate, and severe (if reporting severity). Multivariable logistic regression models were used to examine the bi-directional associations adjusted for within-study correlation. RESULTS At baseline, the prevalence of VMS (40%, range 13-62%) and depressed mood (26%, 8-41%) varied substantially across studies, and a strong dose-dependent association between VMS and likelihood of depressed mood was found. Over 3 years of follow-up, women with often/severe VMS at baseline were more likely to have subsequent depressed mood compared with those without VMS (odds ratios (OR) 1.56, 1.27-1.92). Women with often/severe depressed mood at baseline were also more likely to have subsequent VMS than those without depressed mood (OR 1.89, 1.47-2.44). With further adjustment for the degree of sleep difficulties at baseline, the OR of having a subsequent depressed mood associated with often/severe VMS was attenuated and no longer significant (OR 1.13, 0.90-1.40). Conversely, often/severe depressed mood remained significantly associated with subsequent VMS (OR 1.80, 1.38-2.34). CONCLUSIONS Difficulty in sleeping largely explained the relationship between VMS and subsequent depressed mood, but it had little impact on the relationship between depressed mood and subsequent VMS.
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Affiliation(s)
- Hsin-Fang Chung
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Nirmala Pandeya
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Annette J. Dobson
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Diana Kuh
- Medical Research Council Unit for Lifelong Health and Ageing at University College London, London, UK
| | - Eric J. Brunner
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Sybil L. Crawford
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Nancy E. Avis
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC, USA
| | - Ellen B. Gold
- Department of Public Health Sciences, University of California, Davis, CA, USA
| | - Ellen S. Mitchell
- Family and Child Nursing, School of Nursing, University of Washington, Seattle, WA, USA
| | - Nancy F. Woods
- Biobehavioral Nursing and Health Systems, School of Nursing, University of Washington, Seattle, WA, USA
| | - Joyce T. Bromberger
- Departments of Epidemiology and Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Rebecca C. Thurston
- Departments of Epidemiology and Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - 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, MA, USA
| | - Toyoko Yoshizawa
- Department of Women’s Health Nursing, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Debra Anderson
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Gita D. Mishra
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
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Abstract
Although more than 80% of women experience some degree of psychological or physical symptoms around menopause, both women and clinicians have misconceptions about how hormonal changes relate to menopausal symptoms and psychological conditions. Recently, several large-scale, longitudinal studies have been conducted to better characterize symptoms and changes that occur around menopause. This article offers current evidence for symptoms that occur in the early menopause transition, including vasomotor symptoms, mood changes, sleep problems, and changes in sexual functioning.
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Monteleone P, Mascagni G, Giannini A, Genazzani AR, Simoncini T. Symptoms of menopause - global prevalence, physiology and implications. Nat Rev Endocrinol 2018; 14:199-215. [PMID: 29393299 DOI: 10.1038/nrendo.2017.180] [Citation(s) in RCA: 287] [Impact Index Per Article: 47.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The symptoms of menopause can be distressing, particularly as they occur at a time when women have important roles in society, within the family and at the workplace. Hormonal changes that begin during the menopausal transition affect many biological systems. Accordingly, the signs and symptoms of menopause include central nervous system-related disorders; metabolic, weight, cardiovascular and musculoskeletal changes; urogenital and skin atrophy; and sexual dysfunction. The physiological basis of these manifestations is emerging as complex and related, but not limited to, oestrogen deprivation. Findings generated mainly from longitudinal population studies have shown that ethnic, geographical and individual factors affect symptom prevalence and severity. Moreover, and of great importance to clinical practice, the latest research has highlighted how certain menopausal symptoms can be associated with the onset of other disorders and might therefore serve as predictors of future health risks in postmenopausal women. The goal of this Review is to describe in a timely manner new research findings on the global prevalence and physiology of menopausal symptoms and their impact on future health.
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Affiliation(s)
- Patrizia Monteleone
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, Pisa 56126, Italy
| | - Giulia Mascagni
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, Pisa 56126, Italy
| | - Andrea Giannini
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, Pisa 56126, Italy
| | - Andrea R Genazzani
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, Pisa 56126, Italy
| | - Tommaso Simoncini
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, Pisa 56126, Italy
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Risk factors associated with intensity of climacteric symptoms in Brazilian middle-aged women: a population-based household survey. Menopause 2018; 25:415-422. [DOI: 10.1097/gme.0000000000001022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Perich T, Ussher J, Parton C. "Is it menopause or bipolar?": a qualitative study of the experience of menopause for women with bipolar disorder. BMC WOMENS HEALTH 2017; 17:110. [PMID: 29145856 PMCID: PMC5689207 DOI: 10.1186/s12905-017-0467-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 11/07/2017] [Indexed: 12/25/2022]
Abstract
Background Menopause can be a time of change for women and may be marked by disturbances in mood. For women living with a mental illness, such as bipolar disorder, little is known about how they experience mood changes during menopause. This study aimed to explore how women with bipolar disorder constructed mood changes during menopause and how this impacted on treatment decisions. Methods Semi-structured interviews were undertaken with fifteen women who reported they had been diagnosed with bipolar disorder. Data was analysed using thematic analysis guided by a social constructionist framework. Results Themes identified included ‘Constructions of mood change: menopause or bipolar disorder?’,‘ Life events, bipolar disorder and menopause coming together’; ‘Treatment choices for mood change during menopause’. Conclusions The accounts suggested that women related to the experience of mood changes during menopause through the lens of their existing framework of bipolar disorder, with implications for understanding of self and treatment choices. Electronic supplementary material The online version of this article (10.1186/s12905-017-0467-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tania Perich
- Clinical and Health Psychology Research Initiative (CaHPRI), School of Social Sciences and Psychology, Western Sydney University, Sydney, Australia. .,School of Psychiatry, University of New South Wales, Sydney, Australia.
| | - Jane Ussher
- Translational Health Research Institute, Western Sydney University, Sydney, Australia
| | - Chloe Parton
- Translational Health Research Institute, Western Sydney University, Sydney, Australia
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Mulhall S, Andel R, Anstey KJ. Variation in symptoms of depression and anxiety in midlife women by menopausal status. Maturitas 2017; 108:7-12. [PMID: 29290217 DOI: 10.1016/j.maturitas.2017.11.005] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 11/01/2017] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To examine the association between menopausal status and the risk of symptoms of depression and anxiety in a community-based sample of Australian midlife women. STUDY DESIGN Female participants (mean age 50.6±1.5) who were premenopausal (n=237), perimenopausal (n=249) or naturally postmenopausal (n=225) were drawn from the Personality and Total Health (PATH) Through Life Project, a longitudinal study. MAIN OUTCOME MEASURES Symptoms of depression and anxiety were measured using the Goldberg Depression Scale and Goldberg Anxiety Scale. Generalised linear regression models with a negative binomial log link were used. RESULTS Relative to premenopause and after adjusting for all relevant covariates, being perimenopausal was associated with increased risk of greater symptoms of depression (incidence rate ratio [IRR]=1.29, p=0.001), while being postmenopausal was associated with increased risk of greater symptoms of anxiety (IRR=1.15, p=0.041). Being perimenopausal or postmenopausal was associated with an increased risk of greater symptoms of depression (IRR=1.35, p=0.008; IRR=1.31, p=0.029) and anxiety (IRR=1.22, p=0.030; IRR=1.32, p=0.006) in women without a history of probable major depressive disorder or generalised anxiety disorder. Risk of symptoms did not differ with menopausal status in women with this history. CONCLUSIONS Menopausal status is associated with the risk of symptoms of depression and anxiety. There is a greater likelihood of increased symptoms of depression during perimenopause and symptoms of anxiety during postmenopause. In women without a history of depression or anxiety, the perimenopause and postmenopausal stages are associated with increased risk of greater symptoms of anxiety and depression relative to premenopause.
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Affiliation(s)
- Stephanie Mulhall
- The Australian National University, Centre for Research on Ageing, Health and Wellbeing, Canberra, ACT, Australia; The Australian National University, Research School of Psychology, Canberra, ACT, Australia.
| | - Ross Andel
- The Australian National University, Centre for Research on Ageing, Health and Wellbeing, Canberra, ACT, Australia; University of South Florida, School of Aging Studies, Tampa, FL, United States
| | - Kaarin J Anstey
- The Australian National University, Centre for Research on Ageing, Health and Wellbeing, Canberra, ACT, Australia
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Hantsoo L, Epperson CN. Anxiety Disorders Among Women: A Female Lifespan Approach. FOCUS: JOURNAL OF LIFE LONG LEARNING IN PSYCHIATRY 2017; 15:162-172. [PMID: 28966563 DOI: 10.1176/appi.focus.20160042] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Anxiety symptoms may present differently between women and men, and at different points in the female lifespan. The female lifespan includes distinct epochs of hormonal function, including puberty, the premenstruum, in some women pregnancy or postpartum, and the menopausal transition. These stages give rise to important treatment considerations when treating anxiety in women. When making assessments, the clinician should consider reproductive events and hormonal status, as well as sex differences in anxiety presentation. This review is structured to: 1) Define major epochs of the female lifespan, 2) Provide a brief summary of the major anxiety disorders, with a focus on prevalence and presentation in the context of sex differences and at points in the female lifespan, 3) Describe potential biopsychosocial underpinnings of anxiety disorders among women, 4) Provide guidelines for assessment and differential diagnosis, and 5) Describe treatment options with attention to reproductive events such as pregnancy.
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Affiliation(s)
- Liisa Hantsoo
- Clinical Psychologist & Instructor, Penn Center for Women's Behavioral Wellness, Perelman School of Medicine, University of Pennsylvania
| | - C Neill Epperson
- Professor of Psychiatry and Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania and Director of the Penn Center for Women's Behavioral Wellness and Penn PROMOTES Research on Sex and Gender in Health, Perelman School of Medicine, University of Pennsylvania
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Flores-Ramos M, Silvestri Tomassoni R, Guerrero-López JB, Salinas M. Evaluation of trait and state anxiety levels in a group of peri- and postmenopausal women. Women Health 2017; 58:305-319. [DOI: 10.1080/03630242.2017.1296059] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Mónica Flores-Ramos
- Consejo Nacional de Ciencia y Tecnología, Instituto Nacional de Psiquiatría “Ramón de la Fuente,”, México City, México
| | - Roberto Silvestri Tomassoni
- Departamento de Ginecología y Obstetricia, Instituto Nacional de Perinatología “Isidro Espinosa de los Reyes,”, México City, México
| | - José Benjamín Guerrero-López
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad Nacional Autónoma de México, México City, México
| | - Margus Salinas
- Facultad de Medicina, Universidad Nacional Autónoma de México, México City, México
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Somatic, more than affective, anxiety increases the risk for menopausal hot flashes. Menopause 2016; 23:935-7. [DOI: 10.1097/gme.0000000000000719] [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]
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