The effect of perimenopausal estrogen levels on depression and anxiety: a pilot study
Year 2015,
Volume: 1 Issue: 1, 8 - 13, 04.03.2015
Buket Belkiz Gungor
,
Mahmut Gungor
İbrahim Taymur
,
Rustem Askin
,
Hakan Demirci
,
Yakup Akpinar
,
Almila Ikra Akgul
Abstract
Objectives. Among women in the perimenopausal period, rapid hormonal changes can be seen. In the present study, we aimed to investigate the relationship between depression, anxiety and changing estrogen hormone levels at menopause. Materials and Methods. The research group was composed of 30 perimenopausal women who had FSH levels higher than 20 IU and irregular menses. Anxiety and depression status was assessed with the Hospital Anxiety and Depression Scale. Patients with or without depression or serious anxiety were compared in terms of age, body mass index (BMI), hot flushes, smoking, premenstrual syndrome (PMS) and estrogen levels. Results. There were no statistically significant differences in terms of hot flushes, BMI, smoking, age, and PMS in patients with or without depression/anxiety. Estrogen levels were statistically significantly lower in the group with depression compared to the group without depression (p=0.026). Conclusion. We believe that falling levels of estrogen in the perimenopausal period can be considered to be a risk factor for depression. The possible role of estrogen replacement in the treatment of depression and anxiety should be investigated in further studies.
References
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- Hyde Riley E, Inui TS, Kleinman K. Differential association of modifiable health behaviors with hot flashes in perimenopausal and postmenopausal women. J Gen Intern Med. 2004;19:740-6.
- Soares CN, Almeida OP, Joffe H. Efficacy of estradiol for the treatment of depressive disorder in perimenopausal women. Arch Gen Psychiatry. 2001;58:529-34
- Cohen LS, Soares CN, Joffe H. Diagnosis and management of mood disorders during the menopausal transition. Am J Med. 2005;118:93-97
- Rasgon NL, Altshuler LL, Fairbanks LA. Estrogen replacement therapy in the treatment of major depressive disorder in perimenopausal women. J Clin Psychiatry. 2002;63:45-8.
- Zweifel JE, O’Brien WH. A meta-analysis of the effect of hormone replacement therapy upon depressed mood. Psychoneuroendocrinol. 1997;22:189-212
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Year 2015,
Volume: 1 Issue: 1, 8 - 13, 04.03.2015
Buket Belkiz Gungor
,
Mahmut Gungor
İbrahim Taymur
,
Rustem Askin
,
Hakan Demirci
,
Yakup Akpinar
,
Almila Ikra Akgul
References
- Rasgon N, Shelton S, Halbreich U. Perimenopausal mental disorders: epidemiology and phenomenology. CNS Spectr. 2005;10:471-8.
- Fritz MA, Speroff L. Clinical gynecologic endocrinology and infertility, 8th ed. Philadelphia: Wolkers Kluwer Health/Lippincott Williams & Wilkins, 2011.
- Schmidt P, Rubinow DR. Reproductive ageing, sex steroids and depression. J Br Menopause Soc. 2006;12:178-85.
- Freeman EW, Sammel MD, Liu L. Hormones and menopausal status as predictors of depression in women in transition to menopause. Arch Gen Psychiatry. 2004;61:62-70.
- Schmidt PJ, Haq N, Rubinow DR. A longutidinal evalution of the relationship betweeen reproductive status and mood in perimenopausal woman. Am J Pscyhiatry. 2004;161:2238-44.
- Khan S, Pace J, Cox M, Gau D. Climacteric symptoms in healthy middle aged women. Br J Clin Pract. 1994;84:240-2.
- Aloysi A, Van DYK K, Sano M. Women’s Cognitive and affective health and neuropsychiatry. Mt Sinai J Med. 2006;73:967-75.
- McEwen BS. Genome and hormones: gender difference in physiology. İnvited review: estrogens effects on the brain: multiple sites and molecular mechanisms. J Appl Physiol. 2001;91:2785-801.
- Kruijver FP, Balesar R, Espila AM. Estrogen-receptor beta distribution in the human hypothalamus: similarities and differences with ER alpha distribution. J Comp Neurol. 2003;466:251-77.
- Sherwin B. Hormones, mood and cognitive functioning in postmenopausal women. Obstet Gynecol. 1996;87:20-6.
- Kessler RC, McGonagle KA, Swartz M. Sex and depression in the National Comorbidity Survey, I: lifetime prevalence, chronicity and recurrence. J Affect Disord. 1993;29:85-96.
- Weissman MM, Leaf PJ, Holzer CE. The epidemiology of depression: an update on sex differences in rates. J Affect Disord. 1984;7:179-88.
- Joffe H, Cohen LS. Estrogen, serotonin and mood disturbance: where is the therapeutic bridge? Biol Psychiatry. 1998;44:798-811.
- Studd J, Panay N. Are estrogens useful for the treatment of depression in women? Best Practice & Research Clinical Obstetrics and Gynaecol. 2009;23:63-71.
- Polat A. Prementrüel sendrom. 3P Dergisi. 2001;9:631-8.
- Backstrom T, Boyle H, Baird DT. Persistence of symptoms of premenstrual tension in hysterectomized women. Br J Obstet Gynaecol. 1981;88:530-6.
- Smith RN, Studd JW, Zamblera D. A randomised comparison over 8 months of 100 micrograms and 200 micrograms twice weekly doses of transdermal oestradiol in the treatment of severe premenstrual syndrome. Br J Obstet Gynaecol. 1995;102:475-84.
- Baksua A, Ayasa B, Citak S. Efficacy of tibolone and transdermal estrogen therapy on psychological symptoms in women following surgical menopause. Int J Gynecol Obstet 2005;91:58-62.
- Zigmond AS, Snaith PR. The Hospital anxiety and depression scale. Acta Psychiatry Scand. 1983;67:361-70.
- Aydemir O, Guvenir T, Kuey L, Kultur S. Hastane Anksiyete ve Depresyon Olçegi Turkce Gecerlilik ve Guvenirligi. Turk Psikiyatri Dergisi 1997;8:280-7.
- Avis NE, Brambilla D, McKinlay SM, Vass K. A longitudinal analysis of the association between menopause and depression. Results from the Massachusetts Women’s Health Study. Ann Epidemiol 1994; 4:214-20.
- Almeida OP, Lautenschlager N, Vasi Karam S. Association between physiyological serum concentration of estrogen and the mental health of community-dwelling postmenopousal woman aged 70 years and over. Am J Geriatr Psychiatry. 2005;13:142-9.
- Alpay N, Kıvanç ZE, Ulasoğlu C. The relationship between hormonal profile and depressive symptoms in menopausal women. Dusunen Adam. 2013;26:171-6.
- Sherwin BB. Affective changes with estrogen and androgen replacement therapy in surgically menopausal women. J Affect Disord. 1988;14:17-87.
- Avis NE, Crawford S, Stellato R. Longitudinal study of hormone levels and depression among women transitioning through menopause. Climacteric. 2001;4:243-9.
- Stearns V, Loprinzi CL. New therapeutic approaches for hot flashes in women. J Support Oncol. 2003;1:11-21.
- Kronenberg F. Hot flashes: epidemiology and physiology. Ann NY Acad Sci. 1990;592:52-86.
- Weissman MM, Leaf PJ, Holzer CE. The epidemiology of depression: an update on sex differences in rates. J Affect Disord. 1984;7:179-88.
- Moe KE. Hot flashes and sleep in women. Sleep Med. 2004;8:487- 97.
- Nelson DB, Samel MD, Freeman EQ. Predicting participiants in prospective studies of ovarian aging. Menopause. 2004;11:543-8.
- Jensvold MF, Halbreich U, Hamilton JA. Psychopharmacology and Women: Sex, Gender and Hormones. Washington, American Psychiatric Pres, 1996.
- Harlow BL, Signorello LB. Factors associated with early menopause. Maturitas. 2000;35:3-9.
- Harlow BL, Wise LA, Otto MW. Depression and its influence on reproductive endocrine and menstrual cycle markers associated with perimenopause: the Harvard Study of Moods and Cycles. Arch Gen Psychiatry. 2003;60:29-36.
- Hyde Riley E, Inui TS, Kleinman K. Differential association of modifiable health behaviors with hot flashes in perimenopausal and postmenopausal women. J Gen Intern Med. 2004;19:740-6.
- Soares CN, Almeida OP, Joffe H. Efficacy of estradiol for the treatment of depressive disorder in perimenopausal women. Arch Gen Psychiatry. 2001;58:529-34
- Cohen LS, Soares CN, Joffe H. Diagnosis and management of mood disorders during the menopausal transition. Am J Med. 2005;118:93-97
- Rasgon NL, Altshuler LL, Fairbanks LA. Estrogen replacement therapy in the treatment of major depressive disorder in perimenopausal women. J Clin Psychiatry. 2002;63:45-8.
- Zweifel JE, O’Brien WH. A meta-analysis of the effect of hormone replacement therapy upon depressed mood. Psychoneuroendocrinol. 1997;22:189-212
- Boyd RC, Amsterdam JD. Mood disorders in women from adolescence to late life: an overview. Clin Obstet Gynaecol. 2004;47:515-26.
- Schmidt PJ. Depression, the perimenopause and estrogen therapy. Ann N Y Acad Sci. 2005;1052:27-40.