Depression In Perimenopausal Women Research Articles

Analysis of Demographics Characteristics on Depression in Perimenopausal Staff at a Central General Hospital in Medan, Indonesia

Introduction/Objective Perimenopause is a period where the ovary gradually starts to produce less estrogen. One of the impacts that could happen during perimenopause is the onset of depression arising from hormonal and metabolic disorders due to the significant decrease of ovarium function and secretion of endogenous estrogen. This study was conducted to assess the factors related to depression in perimenopausal women. Methods A multivariate linear regression analysis with a cross-sectional design was conducted at a Central General Hospital in Medan, Indonesia, from October 2023 to January 2024. Subjects were perimenopausal female staff at the hospital who met the inclusion and exclusion criteria. Symptoms of depression were assessed using the Beck Depression Inventory-II (BDI-II) score. Data analysis was conducted using bivariate and multivariate tests with linear regression. Results A total of 111 subjects were included in this study. The median age was 48 years, and the median Body Mass Index (BMI) was 25. The mean depression score based on BDI-II was 12.96±7.084. Bivariate analysis showed significance on age, years of education, total monthly income, BMI, and number of pregnancies. Multivariate analysis showed that total monthly income had the highest correlation amongst other variables, followed by age, while the number of pregnancies had the lowest correlation. Conclusion In conclusion, there was a significance between depression and age, income, and number of pregnancies in perimenopausal staff. On the other hand, there was no significance between depression and years of education, BMI, marital status, and chronic disease.

Osteoporosis and depression in perimenopausal women: From clinical association to genetic causality

BackgroundOsteoporosis and major depressive disorder (MDD) represent two significant health challenges globally, particularly among perimenopausal women. This study utilizes NHANES data and Mendelian randomization (MR) analysis to explore the link between them, aiming to provide a basis for intervention strategies for this group. MethodsThe study analyzed NHANES 2007–2018 data using weighted logistic regression in R software to evaluate the link between MDD and osteoporosis risk. Then, a two-sample MR analysis with GWAS summary statistics was performed, mainly using the IVW method. Additional validation included MR Egger, Weighted Median, Mode, and MR-PRESSO methods. ResultsThe research analysis indicated a significant link between MDD and the risk of osteopenia/osteoporosis. Our analysis revealed a significant positive relationship between MDD and both femoral neck osteoporosis (OR = 6.942 [95 % CI, 1.692–28.485]) and trochanteric osteoporosis (OR = 4.140 [95 % CI, 1.699–10.089]). In analyses related to osteopenia, a significant positive correlation was observed between MDD and both total femoral osteopenia (OR = 3.309 [95 % CI, 1.577–6.942]) and trochanteric osteopenia (OR = 2.467 [95 % CI, 1.004–6.062]). Furthermore, in the MR analysis, genetically predicted MDD was causally associated with an increased risk of osteoporosis via the IVW method (P = 0.013). LimitationsOur study was limited by potential selection bias due to excluding subjects with missing data, and its applicability was primarily to European and American populations. ConclusionIntegrating NHANES and MR analyses, a robust correlation between MDD and osteoporosis was identified, emphasizing the significance of addressing this comorbidity within clinical practice and meriting further investigation.

Disability in Depression among Rural Women during Menopausal Transition

ackground: Disability associated with depression could contribute to declining quality of life of women during menopausal transition. Improving the quality of life of depressed perimenopausal women with disrupted familial, social and/or occupational functioning is one of the valued goals of treatment. This study was conducted with an aim to assess disability due to depression among rural women in menopausal transition. Aims: To study disability due to depression among rural women in menopausal transition. Methods: Sixty-one patients in menopausal transition, diagnosed with major depressive disorder were taken as subjects for the study. Hamilton Rating Scale for Depression and World Health Organization Disability Assessment Schedule (WHODAS 2.0) were applied to assess the severity of depression and disability, respectively. Statistical Analysis Used: Statistical analysis was done using SPSS version 25.

The Effect of Socioeconomic Status to Depression of Perimenopause Women: Pathway Analysis Using the Reserve Capacity Model

Based on the Reserve Capacity Model, this study investigated the effects of pre- and postmenopausal women's socioeconomic status (SES) on depression, focusing on the mediating effects of self-esteem, happiness, and family relationship satisfaction with social network relationships. This cross-sectional study involved secondary analysis of national data on 771 perimenopause women gathered from the 16th Korea Welfare Panel Study (KOWEPS) 2021. A path analysis model was constructed to evaluate the relationship between SES, social network satisfaction, self-esteem, perceived health status, and depression. Data were analyzed using ADANCO 2.3.1 and Mplus 8.4. Although SES had no direct effect on depression, it did affect depression through self-esteem, happiness, and satisfaction with family relationships. The findings of this study indicate that perimenopausal women's personal resources-psychosocial variables such as self-esteem and happiness-had a higher effect on depression than tangible reserves like SES. Therefore, interventions for enhancing self-esteem and happiness may prevent depression in perimenopausal women effectively.

The effect of vitamin D levels on lipid, glucose profiles and depression in perimenopausal women.

Vitamin D deficiency is a significant problem that affects the population living in most countries. This issue is independent by place of residence, sex, age or skin color. It is mainly influenced by the environment we live in and by an unhealthy lifestyle, including bad eating habits. The aim of this study was to evaluate lipid profile, glucose levels, and vitamin D levels, considering sociodemographic variables, smoking and alcohol consumption in perimenopausal women. Depressive mood was also assessed considering sociodemographic variables and vitamin D levels. The study was conducted on a group of 191 women and performed in two stages. The first of them was carried out using a diagnostic survey with the use of a technique questionnaire. The applied research instruments were the author's questionnaire (concerning sociodemographic and selected medical data), and the Beck Depression Inventory. The second stage of the study involved the collection of peripheral blood from each respondent, in order to determine lipid profile, glycemia and serum vitamin D levels. The age of the female respondents ranged from 45 to 65 years, mean age was 53.1 ± 5.37 years, median 53 years. Vitamin D levels were below normal in 78%; 77% had elevated total cholesterol levels; 91.6% of the respondents had high density lipoprotein (HDL) cholesterol levels within the normal range; 64.4% was characterized by too high (low-density lipoprotein) LDL cholesterol, and 84.8% of the women showed normal triglyceride levels. Among the respondents, 91.1% had normal glycemic levels. Analysis of the collected data showed a weak negative correlation between serum vitamin D levels and the levels of total cholesterol (rho=-0.14; p=0.05), LDL cholesterol (rho=-0.16; p=0.026), and triglycerides (rho=-0.22; p=0.002). Only in the case of HDL cholesterol (p=0.067), there was no statistically significant correlation. There were also no statistically significant correlations between serum vitamin D levels and glycemia or severity of depression. 1. The majority of the women did not manifest depressive disorders. Of all factors analyzed, only education was associated with the severity of depressiveness. 2. Smoking adversely affected serum vitamin D levels in the studied women. 3. The cessation of menstruation affected carbohydrate metabolism and vitamin D levels. Blood glucose levels increased with the age of the studied women. 4. Relationships were found between the levels of vitamin D and the levels of total cholesterol, LDL cholesterol, and triglycerides. Therefore, it is important to maintain normal vitamin D levels.

Hormone Replacement Therapy Treatment for Depression in Perimenopausal Women

Hormone Replacement Therapy Treatment for Depression in Perimenopausal Women

Can acupuncture improve sleep quality and anxiety among women during perimenopause?: A protocol for systematic review and meta-analysis.

Background:The decrease in estrogen levels during the perimenopausal period can cause women to have various symptoms such as insomnia, emotional anxiety, and even depression. Therefore, whether the green therapy of acupuncture can improve the sleep quality and anxiety of perimenopausal women has attracted more and more attention. The purpose of this systematic evaluation was to assess the efficacy of acupuncture on insomnia and anxiety in perimenopausal women.Methods:We will search for clinical observational pilot studies or cohort studies of acupuncture for insomnia, anxiety, or depression included in PubMed, Cochrane Library, Embase, Web of science, China Knowledge Network (CNKI), Wanfang, VIP and China Biomedical Database (CBM), etc. The search period will be from the establishment of the database until November 2021. Two researchers will independently perform literature screening, data extraction, and quality assessment. Finally, data analysis will be performed using Revman and Stata software.Results:The purpose of this study was to evaluate the effectiveness and safety of acupuncture therapy for the treatment of insomnia, anxiety, and depression in perimenopausal women.Conclusion:This study will provide new evidence on the effectiveness and safety of acupuncture for the treatment of insomnia, anxiety, and depression in perimenopausal women, and provide additional options for clinicians and patients to improve insomnia and anxiety.Registration Number:INPLASY2021120012

Reduced Plasma Estradiol Levels are Associated with Sleep Apnea in Depressed Peri- and Post-Menopausal Women.

ObjectiveThis study aimed at investigating the correlation between estradiol and sleep apnea among women with major depressive disorders during the perimenopausal and postmenopausal periods.MethodsA total of 84 perimenopausal and postmenopausal women diagnosed with depression, and who had been subjected to whole-night polysomnography (PSG) were retrospectively studied. They were assigned into two groups based on the presence of OSA (apnea–hypopnea index (AHI)≥5) (OSA vs non-OSA). The correlation between estradiol levels and apnea–hypopnea index were assessed by logistic regression models after adjusting for age, body mass index (BMI), Hamilton Depression Rating Scale (HAMD), Pittsburgh Sleep Quality Index (PSQI), apnea frequency and progesterone.ResultsAmong the 84 patients, 45.23% had OSA. Estradiol levels were significantly elevated in non-OSA than in OSA patients (p<0.05). Univariate analysis revealed that elevated estradiol levels are associated with reduced odds of OSA (odds ratio [OR] 0.92, 95% confidence interval [CI] 0.875–0.966, p = 0.001). Multivariate analyses showed that low estradiol levels (OR = 0.859, 95% CI 0.826–0.991, p = 0.031), higher HAMD scores (OR = 1.212, 95% CI 1.012–1.453, p = 0.037), higher apnea frequency (OR = 2.493, 95% CI 1.389–4.473, p = 0.002) and higher BMI (OR=1.635, 95% CI 1.136–2.353, p = 0.008) are correlated with OSA.ConclusionThe ratio of depressed perimenopausal to postmenopausal women comorbid OSA was high. Higher BMI, low estradiol levels, high apnea frequency and high HAMD scores were correlated with OSA diagnosis and could be potential diagnostic markers for OSA in depressed perimenopausal and postmenopausal women. Reduced estradiol levels were correlated with an increased risk of OSA among depressed perimenopausal and postmenopausal women.

Predictors of irritability symptoms in mildly depressed perimenopausal women

ObjectiveIrritability is a highly burdensome complaint, commonly, but not universally, linked with depressive symptoms. While increased variability in estradiol has been associated with depressive symptoms during perimenopause, more insight is needed into reproductive hormone dynamics and other factors that predispose perimenopausal women to irritable mood. MethodsAmong 50 mildly depressed perimenopausal women (mean (SD) age 48.4 (3.9) years), severity of irritability symptoms (on Symptom Questionnaire Hostility subscale, range 0–23) was assessed weekly for eight weeks, concurrent with potential predictors. Associations between these were examined using generalized estimating equating models. ResultsMost women (82.0%) reported having moderate to severe irritability at least once. However, the severity of irritability was highly variable from week-to-week (between-subject mean coefficient of variation [CV] 72.9% and within-subject mean CV 63.7%). In multivariate analyses, less variable serum estradiol levels (standardized β within-person CV −0.23 95%CI [−0.32, −0.14], p < 0.001), greater depression severity (0.45 [0.35, 0.56], p < 0.001), younger age (−0.23, [−0.28, −0.09], p < 0.001), and more frequent vasomotor symptoms (0.14 [0.05, 0.23], p = 0.002) were associated with more irritability. Depression severity explained the largest portion of the variance in irritability, but still not more than 20.3%. Neither crude values, weekly change in, or variability of progesterone or FSH levels were associated with irritability. ConclusionsIrritability was highly prevalent among mildly depressed perimenopausal women. In contrast to depressive symptoms, decreased rather than increased variability in estradiol levels was associated with more irritability. This highlights that irritable mood can be disentangled from depressive symptoms in perimenopausal women and might be linked with different estradiol dynamics.

Efficacy of a novel extract of fenugreek seeds in alleviating vasomotor symptoms and depression in perimenopausal women: A randomized, double-blinded, placebo-controlled study.

The present randomized, double-blinded, placebo-controlled study investigated the effect of a standardized fenugreek extract (FHE) on perimenopausal discomforts and its influence on hormonal balance and safety. Healthy women characterized with perimenopausal symptoms (n=48), as assessed by MRS questionnaire, were randomized either to FHE (n=24) or placebo (n=24) and supplemented with 250mg×2/day for 42days. Both inter and intra-group comparison revealed a significant improvement in somatic, psychological, and urogenital scores in FHE group, especially for hot flashes (25.9%), night sweats (26.5%), depression (31.8%), and insomnia (21.6%). Further hormone analysis revealed an enhancement in serum estradiol (18.9%), free testosterone (38.2%), and progesterone (19.9%) concentrations and a significant decrease in FSH (38.2%) and SHBG (21.1%) concentrations toward establishing a hormonal balance among FHE-group; without significant changes in other clinical safety parameters. Thus, FHE supplementation offered a significant reduction in vasomotor effects and depression in perimenopausal women, without any adverse effects PRACTICAL APPLICATIONS: Fenugreek is a popular kitchen spice and Ayurvedic medicine for a variety of health conditions including diabetes, hypercholesterolemia, hepatotoxicity, gastritis, and also for a variety of hormone-related health conditions such as sexual functions, lactation, osteoporosis, PCOS, and post/perimenopausal discomforts. Fenugreek is rich in alkaloids, steroidal saponins, flavonoids and 4-hydroxyisoleucine. The present randomized-controlled study investigated the plausible application of a standardized hydro-ethanolic extract of fenugreek seeds (FHE) having a unique 3:1 ratio for protodioscin to trigonelline in the management of perimenopausal discomforts. It was observed that FHE at a dosage of 250mg×2/day for 42days significantly reduced the discomforts, especially vasomotor symptoms and depression, and helped to attain a hormonal balance without any adverse effects or deviations in clinical safety parameters. Thus, FHE could be a potential natural agent for the management of post and perimenopausal discomforts and has to be explored in future studies.

The Effect of Whole Blood Lead (Pb-B) Levels on Changes in Peripheral Blood Morphology and Selected Biochemical Parameters, and the Severity of Depression in Peri-Menopausal Women at Risk of Metabolic Syndrome or with Metabolic Syndrome.

The aim of our study was to assess the impact of whole blood lead (Pb-B) levels on changes in peripheral blood morphology and selected biochemical parameters, and the severity of depression in peri-menopausal women at risk of metabolic syndrome (pre-MetS) or with metabolic syndrome (MetS). The study involved 233 women from the general population of the West Pomeranian Province (Poland) aged 44–65 years. The intensity of menopausal symptoms and the severity of depression was examined using the Blatt–Kupperman Index (KI) and the Beck Depression Inventory (BDI). C-reactive protein (CRP), insulin, glucose, glycated hemoglobin (HbA1C), high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, triglyceride levels (TG), cortisol, morphology of blood cells and homeostasis model assessment for insulin resistance (HOMA-IR) and Pb-B was measured. Women with MetS had higher levels of glucose, HbA1C, HDL, LDL, TG, cortisol, insulin and higher HOMA-IR. No significant differences in Pb-B were observed between pre-MetS and the control group, and between pre-MetS and the MetS group. A significant correlation was noticed between Pb-B vs. the percentage of monocytes in blood, and blood cortisol levels in women with MetS; Pb-B vs. lymphocyte count and HbA1C in the pre-MetS group, as well as in the BDI scores between the MetS and pre-MetS group. We cannot clearly state that exposure to Pb is an environmental factor that can be considered as a risk factor for MetS in this studied group.

Association analysis between vitamin D level and depression in women perimenopause: A protocol of systematic review and meta-analysis.

Background:In recent decades, many researches manifested that the perimenopause is a window of vulnerability for the development of both depressive symptoms and major depressive episodes. Some scholar thought that those women diagnosed with depression may be particularly sensitive to changes in the hormonal milieu experienced premenstrual, during the postpartum period or during the menopause transition in. Risk factors for depressive symptoms during the perimenopause include prior standardized mean difference (MDD), psychosocial factors, anxiety symptoms, and reproductive-related mood disturbance. However, active vitamin D (VD), exerts protective and regulatory effects on the brain dopamine system and suggests that similar to the antidepressant. Therefore, serum 25(OH)D level may be negatively correlated with the perimenopausal depression.Methods:The study only selects clinical randomized controlled trials of depression in perimenopausal women. We will search each database from the built-in until October 2020. The English literature mainly searches Cochrane Library, PubMed, EMBASE, and Web of Science. While the Chinese literature comes from CNKI, CBM, VIP, and Wangfang database. Meanwhile, we will retrieve clinical trial registries and grey literature. Two researchers worked independently on literature selection, data extraction, and quality assessment. The dichotomous data is represented by relative risk, and the continuous is expressed by mean difference or standard mean difference, eventually the data is synthesized using a fixed effect model or a random effect model depending on the heterogeneity. The serum vitamin D level, Hamilton Depression Scale, or Beck Depression Inventory or Zung self-rating depression scale or patient health questionnare-9 were evaluated as the main outcomes. While several secondary outcomes were also evaluated in this study. The statistical analysis of this Meta-analysis was conducted by RevMan software version 5.3.Results:This meta-analysis will further determine the association analysis between VD level and depression in women perimenopause.Conclusion:This study determines the VD level is related to the occurrence of depression in perimenopausal women.

Obstetrician-gynecologists' screening and management of depression during perimenopause.

Depression in women is more common during perimenopause (the time period around and during menopause) than pre and postmenopause. Obstetrician-gynecologists (ob-gyns) play a vital role in the detection and management of depression symptoms in women because for many women ob-gyns are the first and most frequent point of medical contact. This study assessed ob-gyns' screening practices and management of depression in perimenopause. A survey regarding depression during perimenopause was sent to 500 practicing ob-gyns who were fellows of the American College of Obstetricians and Gynecologists and members of the Collaborative Ambulatory Research Network. The survey response rate was 41.8% (209 of 500 surveys returned). Over a third of respondents (34.1%) reported that they did not regularly screen perimenopausal patients for depression. Higher-quality education about depression, respondent sex, and personal experience with depression were associated with higher rates of screening. While 85.7% of respondents believed that they could recognize depression in perimenopausal women, only about half (55.8%) were confident in their ability to treat these patients. Increased education of ob-gyn physicians related to depression during perimenopause may increase the screening and treatment of women during this phase of life.

Double-blind randomised investigation of tibolone alone or in adjunct to standard antidepressant treatment for depression in perimenopausal women

To determine whether depressive symptoms are associated with ovulation or reproductive hormone concentrations in eumenorrheic women without a reported diagnosis of clinical depression.A prospective cohort of 248 regularly menstruating women, aged 18 to 44 years (27.3 ± 8.2) were evaluated for depressive symptoms at baseline using the 20-item Center for Epidemiological Studies Depression (CES-D) scale and categorized dichotomously (<16, no depressive symptoms [92%] vs. ≥16, depressive symptoms [8%]). Serum concentrations of estradiol, progesterone, luteinizing hormone, and follicle-stimulating hormone were measured up to eight times per cycle for up to two menstrual cycles. Linear mixed models estimated associations between depressive symptoms and hormone concentrations, whereas generalized linear mixed models assessed their relationship with sporadic anovulation.No significant associations were identified between depressive symptoms and reproductive hormone levels (all P > .05) or the odds of sporadic anovulation (adjusted odds ratio, 1.1; 95% confidence interval, [0.02–5.0]), after adjusting for age, race, body mass index, perceived stress level, and alcohol consumption.Despite reported associations between mental health and menstrual cycle dysfunction, depressive symptoms were not associated with reproductive hormone concentrations or sporadic anovulation in this cohort of regularly menstruating women with no recent (within 1 year) self-reported history of clinical depression.

Analysis of the level of depression in perimenopausal women according to sociodemographic characteristics

Abstract Introduction. Historically, perimenopausal period was thought to be associated with mood disorders. Despite many studies, the relationship between menopause and depressed mood has not been fully explained. Aim. The objective of the study was analysis of the level of intensity of depression among women at perimenopausal age according to sociodemographic characteristics. Material and methods. The study covered 268 perimenopausal women who reported to outpatient departments in the city of Lublin. The criteria for the qualification of women into the study group were: age 45-55 years, lack of mental disorders and lack of diseases requiring hospitalization during the period of study. The study was conducted with the method of a diagnostic survey with the use of the Beck Depression Inventory (BDI) and a questionnaire designed by the authors in order to collect demographic data. Results. The mean BDI values obtained in the presented study according to respondents’ age and monthly income showed the lack of depression or mild depression in the group of the women examined. In addition, the mean level of depression according to marital status confirmed the lack of depression in the group of married women, whereas mild depression in the group of those who were single. Conclusions. Analysis of the results of the study indicated that age and marital status were not related with the respondents’ level of depression. Women who possessed a university education had a lower level of depression, compared to those who had elementary/elementary vocational or secondary school education level. Women whose material standard was higher had a lower level of depression. Women who have a poor material standard and lower level of education should be covered by a special psycho-prophylactic care.

Incidence of Oral Lichen Planus in Perimenopausal Women: A Cross-sectional Study in Western Uttar Pradesh Population.

Background:Hormonal fluctuations during menopause lead to endocrine changes in women, especially in their sex steroid hormone production. Studies have documented the role of estrogen and progesterone (Pg) on autoimmune disorders such as multiple sclerosis, systemic lupus erythematosus, and rheumatoid arthritis. Lichen planus (LP), an autoimmune disorder, seen frequently in perimenopausal women, may also get affected by sex steroid hormones, but no direct relationship has been established yet.Aim:The aim of this study is to find the incidence of oral LP (OLP) in perimenopausal women and evaluate the factors associated with it.Materials and Methods:This cross-sectional study was conducted over a period of 1 year. All the perimenopausal women (44.69 ± 3.79 years) who came to the dental outpatient department were evaluated for the presence of LP and various factors associated with it. Depression Anxiety Stress Scale-21 questionnaire was used for psychometric evaluation of perimenopausal women.Results:According to our study, incidence of LP in postmenopausal women was 10.91%, which is higher than incidence of LP in general population, i.e., 0.5% to 2.0%. Incidence of LP increased with the severity of depression in perimenopausal women (P = 0.000).Conclusion:The incidence of OLP is higher in perimenopausal women than in general population and increases significantly with increase in the severity of depression. LP in perimenopausal women can be mediated by declined level of estrogen and Pg directly or indirectly through causing depression that can trigger LP.

Association of estradiol with sleep apnea in depressed perimenopausal and postmenopausal women: a preliminary study.

Women's risk of obstructive sleep apnea (OSA) increases substantially during and after the menopausal transition, when depression risk is also elevated, raising the possibility that estrogen withdrawal contributes to OSA vulnerability, in turn contributing to mood disturbance. We examined the association between estradiol levels and OSA in depressed peri- and postmenopausal women. Thirty depressed peri-/postmenopausal women (mean body mass index [BMI] 30.82 kg/m) without known OSA completed routine polysomnography concurrent with serum estradiol levels. Estradiol in women with apnea-hypopnea indices (AHI) ≥15 indicating moderate-to-severe OSA was compared against those with AHI less than 15 using logistic regression adjusting for age and BMI. Thirteen women (43%) had AHI ≥15 (median AHI 21.6). Estradiol levels were lower (P = 0.02) in those with OSA (median 19, interquartile range 9-25 pg/mL) than without OSA (median 29, interquartile range 19-66 pg/mL). On univariate analysis, higher estradiol was associated with reduced odds of OSA (odds ratio 0.95, 95% CI 0.90-0.99, P = 0.04). After adjusting for age and BMI, estradiol levels remained associated with lower odds of OSA (odds ratio 0.90), but the association was no longer statistically significant (95% CI 0.76-1.05, P = 0.18). Montgomery Åsberg Depression Rating Scale scores did not differ between those with and without OSA. These preliminary results suggest that, in addition to higher BMI and age, lower estradiol may be associated with increased OSA risk in depressed women during the peri- and postmenopause, raising the possibility that estradiol withdrawal associated with menopause influences upper-airway patency in women.

Association Between MKP-1, BDNF, and Gonadal Hormones with Depression on Perimenopausal Women.

Background: Studies suggest that brain-derived neurotrophic factor (BDNF) exerts effects on the neuronal function of hippocampal neurons and increases hippocampal mitogen-activated protein kinase phosphatase-1 (MKP-1) expression, which causes depressive behaviors in rat or mouse. Here we focus on the change of serum MKP-1, BDNF, testosterone (T), and estradiol (E2) levels, in order to test the hypothesis that dysregulation of MKP-1, BDNF, T, and E2 are associated with depression in perimenopausal women.Methods: Women with depression, after meeting criteria in the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, for mental and behaviural disorders and the 17-item Hamilton Depression Rating Scale (HDRS), were included in the study. Psychosocial data and blood samples were obtained from the subjects in the study, including 38 perimenopausal and 32 young women with depression, 26 healthy control perimenopausal women, and 34 young women.Results: Serum MKP-1 levels were higher and T was lower in the women with depression compared to controls (p<0.05), and depressed perimenopausal women exhibited the highest serum MKP-1 levels and lowest T levels. Logistic regression analyses showed that MKP-1 levels were positively correlated with HDRS scores in the women, and T levels were inversely correlated with HDRS scores in the perimenopausal women (p<0.05).Conclusions: This study suggests that high serum MKP-1 levels are associated with depression in women, and this association did not appear to be confounded by age. Further, the results provide evidence of association between depressive symptom severity and increasing serum MKP-1 levels in women, and decreasing T levels in perimenopausal women.

Hormone therapy and mood in perimenopausal and postmenopausal women: a narrative review.

Between 15% and 50% of women experience depressive symptoms during the menopausal transition; in 15% to 30% of perimenopausal women, they are severe enough to be regarded as a depressive disorder. Fluctuations in gonadal hormone levels are thought to contribute to these depressive conditions. Hormone therapy is commonly used to alleviate climacteric symptoms, but its effects on mood are less clear. We narratively reviewed the literature on the effects of different types of hormone therapy on mood. Using PubMed/Medline, we searched for studies of hormone therapy in relation to depressive symptoms and disorders in perimenopause and postmenopause. A number of studies consistently reported estrogen therapy to be effective in improving mood in perimenopausal women. However, its efficacy for overt depression or during postmenopause was more questionable. The progestogenic component in combined hormone therapy was found to potentially counteract the beneficial influence of estrogens on mood and to even induce negative mood symptoms. In specifically focused studies, a combination of hormone therapy and antidepressants was effective in depressed perimenopausal and postmenopausal women. Hormone therapy may contribute to alleviating menopause-related depressive symptoms. Its administration should be followed across time and should be specifically individualized. In cases of more severe depressive conditions, a combination of antidepressant and hormone therapy should be considered.

Gonadal hormone levels and platelet tryptophan and serotonin concentrations in perimenopausal women with or without depressive symptoms

Introduction: The etiology of depressive symptoms associated with the transition to menopause is still unknown; hormonal changes, serotonergic system or insomnia, could be a trigger to depressive symptomatology. The aim of the present study was to evaluate gonadal hormonal levels, platelet serotonin concentrations and platelet tryptophan concentrations in a group of depressed perimenopausal women and their healthy counterparts.Methods: A total of 63 perimenopausal women between 45 and 55 years old were evaluated; of these, 44 were depressed patients, and 19 were perimenopausal women without depression. The instruments that were applied included the Center for Epidemiologic Studies Depression Scale (CES-D), the Hamilton Depression Rating Scale (HDRS) and the Green Climacteric Scale (GCS); gonadal hormone levels and platelet tryptophan and serotonin concentrations were measured in all participants. Differences in hormonal levels and tryptophan and serotonin concentrations were evaluated with respect to specific symptoms, such as insomnia, hot flashes, nervousness, depressed mood and loss of interest.Results: No differences between groups were observed with respect to hormonal levels and tryptophan and serotonin concentrations; mean sleep hours and insomnia were significantly correlated with platelet tryptophan concentrations.Conclusions: In this sample, all symptoms of depression could not be explained by platelet tryptophan and serotonin concentrations and hormonal levels; differences were observed only when we evaluated insomnia and hot flashes.