Depression In Postmenopausal Women Research Articles

Factors affecting suicidal ideation among premenopausal and postmenopausal women.

WHAT IS KNOWN ON THE SUBJECT?: Pre- and postmenopausal women (PPW) experience changes in physical, psychological and social health. South-East Asia's female suicide rate is the highest compared with other countries, and the suicide rate of PPW in these countries continues to increase. The most influential factor in Asian women's suicidal ideation is family conflict; specifically, if PPW in South Korea cannot express their anger, it results in a culture-bound syndrome called "Hwa-Byung." However, there is a lack of research on Asian PPW. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This study found differences in individual- and community-level factors affecting suicidal ideation between pre- and postmenopausal women. Individual factors that commonly affected suicidal ideation were experiencing violence, stress and depression. Individual factors that affected the suicidal ideation of premenopausal women more than postmenopausal women were religious beliefs, alcohol use and chronic disease. Community level factors affecting suicidal ideation were locational depression and locational counselling for stress in premenopausal women and locational counselling for depression in postmenopausal women. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health nurses could help prevent suicide by developing and applying community-based programmes for PPW, considering the specific socio-economic and cultural context and characteristics of Asian women. Mental health nurses could help PPW participate in programmes by preparing various interventions such as case management, personal counselling, physical activity, home-based mental health services, cognitive behavioural therapy and digital interventions for self-management. Mental health nurses need to prepare various methods such as online, offline, individual and group methods to work effectively in any social situation. ABSTRACT: Introduction Pre- and postmenopausal women (PPW) experience physical and psychological changes with hormonal changes. Among Asian middle-aged women, family and culture affect suicidal ideation, and the suicide rate among this population is increasing. There are few existing research on suicidal ideation among Asian PPW. Aim We examined individual- and community-level factors that predict suicidal ideation among PPW. Method Large-scale panel data from 5,154 South Korean PPW aged 35-64years were used in a series of multilevel logistic regression analyses to examine factors associated with suicidal ideation at individual and community levels. Results Among premenopausal women, religious beliefs, alcohol use, chronic disease, experience of violence, stress and depression were individual-level factors. Locational depression and locational counselling for stress were community-level factors. Among postmenopausal women, experience of violence, stress, depression and perceived health status were individual level factors, and locational counselling for depression was a community level factor. Discussion Suicidal ideation among PPW is affected by both individual and community level factors. Nurses must comprehensively determine what risk factors affect suicidal ideation through various intervention methods-including online, offline, individual and group methods-while considering socio-economic situations. Implications for Practice Mental health nurses should provide targeted biopsychosocial interventions targeting psychosocial and physical problems and promoting the use of community resources to reduce PPW's suicidal ideation.

Neuroprotective effects of vitamin D and 17ß-estradiol against ovariectomy-induced neuroinflammation and depressive-like state: Role of the AMPK/NF-κB pathway

Estrogen replacement therapy (ERT) has been proven to relieve menopausal-related mental disorders including depression in postmenopausal women. However, the unsafety of ERT hinders its clinical use. In this study, we would evaluate whether vitamin D (VD), a hormone with optimal safety profile, could relieve the depressive-like symptom in ovariectomized (OVX) rats. Furthermore, we would determine whether vitamin D and 17β-estradiol (E2) exert neurological function through their immunomodulatory effect in OVX rats. Middle-aged female SD rats were randomly divided into four groups, namely, control (SHAM), OVX, OVX + VD, and OVX + E2. Vitamin D (calcitriol, 100 ng/kg) and 17β-estradiol (30 μg/kg) had been daily gavaged in the OVX + VD and OVX + E2 group, respectively. After 10-week administration, vitamin D and 17β-estradiol both showed anti-depressive-like activity in the OVX rats. Using the method of immunofluorescent staining and western blot, vitamin D and 17β-estradiol were demonstrated to upregulate each other's receptors, including VDR, ERα, and ERβ in the hippocampus of OVX rats. Additionally, the upregulation of VDR, calbindin-D28k, and calbindin-D9k suggested that the vitamin D signaling system was amplified by vitamin D and 17β-estradiol. Vitamin D and 17β-estradiol showed neuroprotective effects by decreasing OVX-induced apoptosis and neuronal damage, regulating the AMPK/NF-κB signaling pathway, and reducing the proinflammatory cytokines (IL-1β, IL-6, and TNFα), as well as iNOS and COX-2 in the hippocampus of OVX rats. Collectively, the present study demonstrated that vitamin D and 17β-estradiol could upregulate each other's receptors and regulate the AMPK/NF-κB pathway to relieve the OVX-induced depressive-like state. The results could stimulate translational research towards the vitamin D potential for prevention or treatment of menopause-related depression.

SUN-303 Effects of Open-Label, Adjunctive Ganaxalone Treatment on Resistant Depression in Postmenopausal Women: A Pilot Study

Resistance to selective serotonin reuptake inhibitor and serotonin norepinephrine reuptake inhibitor treatment occurs in about 50% to 70% of patients with major depressive disorder (MDD), a condition associated with significant morbidity that affects women at higher rates than men. Few well-tolerated, effective augmentation therapies are available for such patients, and new therapeutic strategies for resistant depression are needed. The neuroactive steroid metabolite of progesterone, allopregnanolone, is a positive allosteric modulator of GABAA receptors and a putative treatment for mood disorders. We performed a pilot study to determine whether an oral allopregnanolone analog (ganaxolone) may be effective adjunctive therapy for resistant depression in postmenopausal women. Ten postmenopausal women (age 62.8±6.3 years, range 53–69) with resistant depression [current DSM-IV major depressive episode per the Structured Clinical Interview for DSM-IV, Montgomery-Asberg Depression Rating Scale (MADRS) ≥16 despite treatment with an adequately dosed antidepressant for ≥6 weeks] were studied. Open-label ganaxolone (225 mg BID, increased to 450 mg BID if tolerated) was administered for 8 weeks, followed by a 2-week taper. Mean total MADRS depression score (primary endpoint) decreased by 8 weeks [24.4±1.6 (SEM) to 12.8±2.9, p=0.015] and persisted over the two-week taper (p=0.019); 44% of subjects experienced response (score decrease ≥50%) and remission (final score <10), which persisted in 100% and 50% of subjects at 10 weeks, respectively. Secondary endpoints showed significant improvement, including the Inventory of Depressive Symptomatology-Self-Report (IDS-SR; p=0.003), MADRS Reduced Sleep subscale (p<0.001), Symptoms of Depression Questionnaire (SDQ) total score (p=0.012), and SDQ subscales for disruptions in sleep quality (p=0.003) and changes in appetite and weight (p=0.009) over 8 weeks. No significant effects were observed on quality of life or sexual function. All subjects experienced sleepiness and fatigue; 60% experienced dizziness. In conclusion, adjunctive ganaxolone in this open label pilot study appeared to exert antidepressant effects in postmenopausal women with resistant depression but produces sedation with twice-daily dosing. The observed positive effects on sleep and the potential for sustained treatment effects merit further study, as ganaxolone may be particularly beneficial to patients with depression and insomnia. Randomized, placebo-controlled studies are necessary to rule out placebo effects. Given the sedation experienced by most participants, nighttime dosing only should be considered for future studies. Finally, should rigorous studies confirm an antidepressant effect, it will be important to identify subsets of women who respond (e.g. women with neuroactive steroid dysregulation) and mechanisms of action.

Comparing the Prevalence of Depression in Postmenopausal Women With and Without Urinary Incontinence

Comparing the Prevalence of Depression in Postmenopausal Women With and Without Urinary Incontinence

Improving menopausal symptoms and reducing depression in postmenopausal women: Effectiveness of transferring experiences in group education.

INTRODUCTION:One of the most critical stages of women's lives is menopause. Meanwhile, group training can have a significant effect on reducing menopausal symptoms. The aim of this study was to investigate the effectiveness of group training on reducing menopausal symptoms in postmenopausal women.METHODS:This study was a randomized controlled trial. The study population was 96 postmenopausal women visiting health centers in the city of Shazand (Markazi Province, Iran). Data collection tools in this study were the Menopausal Rating Scale Questionnaire and the Beck Depression Inventory. Group training intervention consisted of four training sessions. The duration of each session was 2 h. The questionnaires were completed in two stages of pre- and post-test (8 weeks later) for the intervention and control groups. Data were analyzed using descriptive statistics (absolute and relative frequency, mean and standard deviation) and analytical statistics (independent t-test, paired t-test, and analysis of covariance).RESULTS:The mean age in the intervention group and the control group was 49.93 ± 3.44 and 51.66 ± 2.93 years, respectively. In the intervention group, the mean menstrual time was 2.37 ± 167 years and in the control group, the mean time elapsed from the last menstrual period was 3.91 ± 2.68 years. The mean scores of menopausal physical symptoms (F = 58.69), menopausal symptoms (F = 43.45), menopausal urinary and genital symptoms (F = 33.50), and depression (F = 58.25) had a significant decrease in intervention group, while in the control group, these changes were not significant (P < 0.001).CONCLUSION:Regarding the findings of this study, which indicates the effect of group training program on the improvement of physical, psychological, urinary and genital symptoms, and menopausal depression, it seems that group training in menopause can be an effective method.

Depression, Quality of Life, and Self-Esteem of Moroccan Postmenopausal Women with Osteoporosis before the Occurrence of Fractures.

ObjectivesPrevious researches have investigated depression in postmenopausal women (PMW) with osteoporosis and fractures, but little is known regarding Moroccan PMW without fractures. We investigated depression prevalence and severity in Moroccan PMW with osteoporosis without fractures and its relationship with quality of life (QoL) and physical and psychological state.MethodsThis cross-sectional study enrolled 100 PMW with osteoporosis without fractures. Depressive symptoms, QoL, self-esteem, and fatigue were evaluated using the Patient Health Questionnaire-9 (PHQ-9), Arabic version of ECOS-16 questionnaire, Rosenberg self-esteem scale, and Arabic version of the Multidimensional Assessment of Fatigue scale, respectively. A questionnaire including sociodemographic factors, bone density features, pain intensity, and sleep disturbance was completed.ResultsOverall, 58% patients suffered from depression and 55% from pain (63.8% depressed women vs. 42.9% nondepressed patients; P = 0.03). Bone mineral density, lumbar spine T-score, ECOS-16, and self-esteem in depressed and nondepressed women were 0.791 (0.738–0.840) vs. 0.835 (0.790–0.866); −3.25 (−3.8 to −2.875) vs. −2.9 (−3.425 to −2.700), P = 0.02; 2.338 ± 0.605 vs. 1.638 ± 0.455; and 13.517 ± 5.487 vs. 18.404 ± 5.771, P < 0.0001, respectively. Depression severity correlated with pain, QoL, self-esteem, and fatigue (r = 0.367, r = −0.390, r = −0.390, and r = 0.369, respectively; P < 0.0001) as well as lumbar spine bone mineral density and T-score (r = −0.258 and r = −0.255, respectively; P = 0.01). Multiple linear regression analysis revealed impaired QoL (β = 0.526; P < 0.0001), fatigue (β = 0.177; P = 0.02), and lower self-esteem (β = −2.170; P = 0.005) as the strongest risk factors of depression.ConclusionsOur study shows that even without fractures, Moroccan PMW with osteoporosis suffered from depression, pain, impaired QoL, and lower self-esteem.

Aromatase (CYP19A1) gene variants, sex steroid levels, and late-life depression.

Sex differences in psychiatric disorders are common and could involve sex steroids. Aromatase, the product of the CYP19A1 gene, is the key enzyme in the conversion of androgen to estrogen. Whether CYP19A1 variants could be associated with depression differently in men and women has not been examined. This population-based study included 405 men and 602 women aged ≥65 years. A clinical level of depression (DEP) was defined as having a score ≥16 on the Center for Epidemiology Studies Depression scale or a diagnosis of current major depression based on the Mini-International Neuropsychiatric Interview and according to DSM-IV criteria. Seven single-nucleotide polymorphisms (SNPs) spanning the CYP19A1 gene were genotyped and circulating levels of estradiol and testosterone were determined. Multivariable analyses were adjusted for age, body mass index, ischemic pathologies, cognitive impairment, and anxiety. Five SNPs were associated with DEP in women specifically and this varied according to a history of major depression (p-values .01 to .0005). Three SNPs were associated with an increased risk of late-life DEP in women without a history of major depression, while two SNPs were associated with a decreased DEP risk in women with a history of major depression and were also associated with higher estradiol levels. Variants of the CYP19A1 gene appear to be susceptibility factors for late-life depression in a sex-specific manner. The polymorphisms decreasing the risk of recurrent depression in postmenopausal women also influence estradiol levels.

Effect of Acupressure versus Aerobic Exercise on Depression in Postmenopausal Women

AbstractBackground: The effect of acupressure and aerobic exer-cise on depression was a hot topic in physical therapy in the past decades. The results of the research available to date showed that acupressure and exercise training might be a promising, additional, safe and economical method to help in improving depression.Aim of Study: This study was conducted to compare the effect of acupressure versus aerobic exercise on depression in postmenopausal women.Material and Methods: A sample of 40 postmenopausal women diagnosed with depression by gynecologist and con-firmed by Zung self-rating depression scale, their ages ranged from 45 to 55 years with body mass index not exceeded 30kg/m2 participated in this study from the outpatient clinic of Kasr Al-Ainy University Hospital, Cairo University. They were distributed into two groups; each consisted of 20 post-menopausal women, Group (A) received acupressure by wearing wrist band for four weeks for 24 hours and Group (B) performing aerobic exercises on treadmill 3 sessions per week for four weeks for a duration 40mins (10mins warming up, 20mins running and 10mins cooling down).Results: Showed that there was a statistically significant decrease in the value of Zung self-rating depression scale measured at post-treatment compared with the pre-treatment in both study Groups (A) and (B) (p=0.001).On the other hand at post-treatment, there was a statistical significant decrease in value of Zung self-rating depression scale in Group B (38.80±3.02) when compared with its cor-responding value in Group A (46.90±3.82) with Z-value= –4.903 and p-value=0.001.Conclusion: Both acupressure and aerobic exercise have significant effect on depression in postmenopausal women but, patients may get additional benefit in improving the depression level through aerobic training program more than the acupressure.

The effect of Hypericum perforatum on postmenopausal symptoms and depression: A randomized controlled trial

ObjectivesHypericum perforatum (St John's wort) is an herbal plant that has antidepressant activity and contains ingredients such as flavonols derivatives, bioflavonoids, proanthocyanidins, xanthones, phloroglucinol, and naphthodianthrones. This study was aimed to test the effect of Hypericum perforatum on hot flashes, menopausal symptoms, and depression in postmenopausal women. Design & settingThis randomized controlled study was conducted on 80 postmenopausal women aged 45–60 in Izeh, Iran. InterventionTwo groups received 270–330 μg of H. perforatum (n = 40) or placebo (n = 40) tablets three times a day for two months. Main outcomesData were collected using a socio-demographic questionnaire, the modified Kupperman index before the intervention and 2, 4, 6 and 8 weeks after intervention. The Hamilton Depression Rating Scale was used to gather data before the intervention and in the 8th week of intervention. The data were analyzed using an independent t-test, chi-square test, and repeated measure test. ResultsSeventy women completed the study and five women from each group withdrew the study. The frequency and intensity of hot flashes and the score of Kupperman scale significantly decreased in the H. perforatum group compared to the control group (p < 0.001). In addition, the intensity of depression significantly decreased in the H. perforatum group compared to the control group. At the end of the study, 80% of women in the intervention group did not have depression compared to only 5.7% in the control group (p < 0.001). ConclusionTreatment with Hypericum perforatum is an efficient way of reducing hot flashes, menopausal symptoms, and depression in postmenopausal women.

Factors Influencing Depression in Postmenopausal Women by Subjective Health Awareness

Factors Influencing Depression in Postmenopausal Women by Subjective Health Awareness

Emerging evidence on the link between depressive symptoms and bone loss in postmenopausal women.

Osteoporosis and depression are major health problems of crisis proportions in postmenopausal women. Researchers have established a relationship between bone loss and depression, although few studies have focused on postmenopausal women. The purposes of this integrative review were to synthesize and summarize the available literature on: 1) the associations between bone loss and depression in postmenopausal women; and 2) potential variables that impact the associations between bone loss and depression in postmenopausal women. After searching the databases PubMed, CINAHL, Embase, and the Cochrane library between 2007 and 2017, 12 articles met the inclusion criteria. The majority of the included studies supported the relationship between depression and bone loss in postmenopausal women, although little information is offered as to why this relationship exists. This review summarizes the research that has been completed on depression and bone loss in postmenopausal women and identifies gaps in the literature. These findings will aid in the planning of future research and the development of health care recommendations.

閉経後女性のうつ病に対するエストロゲン補充療法とその症例提示(合同シンポジウム:心理ストレスによる身体反応,2009年,第1回日本心身医学5学会合同集会(東京))

閉経後女性のうつ病に対するエストロゲン補充療法とその症例提示(合同シンポジウム:心理ストレスによる身体反応,2009年,第1回日本心身医学5学会合同集会(東京))

Novel oestrogen receptor \u03b2-selective ligand reduces obesity and depressive-like behaviour in ovariectomized mice

Hormonal changes due to menopause can cause various health problems including weight gain and depressive symptoms. Multiple lines of evidence indicate that oestrogen receptors (ERs) play a major role in postmenopausal obesity and depression. However, little is known regarding the ER subtype-specific effects on obesity and depressive symptoms. To delineate potential effects of ERβ activation in postmenopausal women, we investigated the effects of a novel oestrogen receptor β-selective ligand (C-1) in ovariectomized mice. Uterine weight, depressive behaviour, and weight gain were examined in sham-operated control mice and ovariectomized mice administered placebo, C-1, or 17β-oestradiol (E2). Administration of C-1 or E2 reduced body weight gain and depressive-like behaviour in ovariectomized mice, as assessed by the forced swim test. In addition, administration of E2 to ovariectomized mice increased uterine weight, but administration of C-1 did not result in a significant increase in uterine weight. These results suggest that the selective activation of ERβ in ovariectomized mice may have protective effects against obesity and depressive-like behaviour without causing an increase in uterine weight. The present findings raise the possibility of the application of ERβ-ligands such as C-1 as a novel treatment for obesity and depression in postmenopausal women.

GABA+ levels in postmenopausal women with mild-to-moderate depression: A preliminary study.

Background:It is increasingly being recognized that alterations of the GABAergic system are implicated in the pathophysiology of depression. This study aimed to explore in vivo gamma-aminobutyric acid (GABA) levels in the anterior cingulate cortex/medial prefrontal cortex (ACC/mPFC) and posterior-cingulate cortex (PCC) of postmenopausal women with depression using magnetic resonance spectroscopy (1H-MRS).Methods:Nineteen postmenopausal women with depression and thirteen healthy controls were enrolled in the study. All subjects underwent 1H-MRS of the ACC/mPFC and PCC using the “MEGA Point Resolved Spectroscopy Sequence” (MEGA-PRESS) technique. The severity of depression was assessed by 17-item Hamilton Depression Scale (HAMD). Quantification of MRS data was performed using Gannet program. Differences of GABA+ levels from patients and controls were tested using one-way analysis of variance. Spearman correlation coefficients were used to evaluate the linear associations between GABA+ levels and HAMD scores, as well as estrogen levels.Results:Significantly lower GABA+ levels were detected in the ACC/mPFC of postmenopausal women with depression compared to healthy controls (P = 0.002). No significant correlations were found between 17-HAMD/14-HAMA and GABA+ levels, either in ACC/mPFC (P = 0.486; r = 0.170/P = 0.814; r = −0.058) or PCC (P = 0.887; r = 0.035/ P = 0.987; r = −0.004) in the patients; there is also no significant correlation between GABA+ levels and estrogen levels in patients group (ACC/mPFC: P = 0.629, r = −0.018; PCC: P = 0.861, r = 0.043).Conclusion:Significantly lower GABA+ levels were found in the ACC/mPFC of postmenopausal women with depression, suggesting that the dysfunction of the GABAergic system may also be involved in the pathogenesis of depression in postmenopausal women.

Association between erythrocyte levels of n-3 polyunsaturated fatty acids and depression in postmenopausal women using or not using hormone therapy

Epidemiologic and clinical studies have suggested that hormone therapy (HT) and n-3 polyunsaturated fatty acids (PUFAs), such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), exert antidepressant effects through regulation of the serotonergic pathway. The present study was conducted to evaluate the hypothesis that erythrocyte levels of n-3 PUFAs and depression were negatively associated in postmenopausal women, particularly those using HT. A total of 214 postmenopausal women were divided into groups defined by depression and HT status. Depression was defined as a Beck Depression Inventory score of at least 14, and the types and durations of HT were obtained from medical records. Erythrocyte levels of EPA, docosapentaenoic acid (DPA), DHA, omega-3 index (sum of EPA + DHA), total n-3 PUFA, and arachidonic acid were significantly higher in women using HT than in those not using HT. There were significant negative correlations between depression and erythrocyte levels of alpha-linolenic acid (r = -0.310), DPA (r = -0.272), DHA (r = -0.209), and total n-3 PUFA (r = -0.234) in women using HT. Multivariate-adjusted logistic regression analysis also showed that depression was negatively associated with the erythrocyte levels of alpha-linolenic acid (P for trend = 0.018), DPA (P for trend = 0.014), and DHA (P for trend = 0.036), only in women using HT. Negative associations between erythrocyte levels of n-3 PUFAs and depression were found in Korean postmenopausal women using HT but not in those not using HT, suggesting a synergistic effect of HT and n-3 PUFAs on depression.

Effects of Hormone Therapy on the Association between Erythrocyte Levels of N‐3 Polyunsaturated Fatty Acids and Depression in Postmenopausal Women

Effects of Hormone Therapy on the Association between Erythrocyte Levels of N‐3 Polyunsaturated Fatty Acids and Depression in Postmenopausal Women

The Effect of Spiritual Intervention on Postmenopausal Depression in Women Referred to Urban Healthcare Centers in Isfahan: A Double-Blind Clinical Trial.

Background:Depression is not only common after menopause, but also affects postmenopausal women more than other women. Some studies show the positive effects of spiritual intervention on postmenopausal women and depressed patients. However, there is inadequate experimental data for supporting the effectiveness of such interventions.Objectives:This study investigated the effect of a spiritual intervention on postmenopausal depression in women referred to urban healthcare centers in Isfahan, Iran.Patients and Methods:A randomized controlled clinical trial was conducted on postmenopausal women referred to the healthcare centers of Isfahan. Sixty-four women with postmenopausal depression were assigned randomly into an experimental group (n = 32) and a control group (n = 32). The experimental group received eight sessions of spiritual intervention while the control group received two sessions of training on healthy diet for postmenopausal women. All subjects in the experimental group and the control group responded to the Beck’s depression inventory at the start of the study, at the end of the fourth week, and a month after the last educational session. In addition to descriptive statistics, the chi-square test, independent samples t-test and repeated measures analysis of variance were used to analyze the data.Results:Before the intervention, the study groups did not differ significantly in terms of mean depression scores (20.76 ± 4.61 vs. 19.58 ± 5.27, P = 0.33). However, immediately after intervention and after one month, the mean depression scores of 11.01 ± 7.85 and 11.21 ± 9.23 in the experimental group were significantly lower than the control group (19.22 ± 4.94 and 19.34 ± 4.92, respectively) (P = 0.001). In repeated measures analysis of variance, Mauchly’s test of sphericity was not significant (P = 0.672), and in the test of within-subjects effects, a significant interaction was found between the spiritual intervention and time.Conclusions:Spiritual intervention effectively could reduce the severity of postmenopausal depression. Considering the high prevalence of depression in postmenopausal women and the effectiveness, simplicity, and affordability of spiritual intervention, using such interventions in postmenopausal women is recommended.

Depressive symptoms and bone mineral density in menopause and postmenopausal women: A still increasing and neglected problem

ObjectiveThe objective of current study was to investigate whether associaction exist between depression and low BMD during menopausal and post-menopausal period.MethodsA cross-sectional descriptive study and 1650 women aged 45–65 years were included during 1182 women agreed to participate (71.6%). Data on body mass index (BMI), clinical biochemistry variables including serum 25-hydroxyvitamin D were collected. The Beck Depression Inventory (BDI) was administered for depression purposes.ResultsA total of 1182 women agreed to participate and responded to the study. The mean age and SD of the menopausal age were 48.71 ± 2.96 with depressed and 50.20 ± 3.22 without depressed (P &lt; 0.001). Also, the mean and SD of postmenopausal age were 58.55 ± 3.27 depressed and 57.78 ± 3.20 without depressed (P &lt; 0.001). There were statistically significance differences between menopausal stages with regards to number of parity, and place of living. There were statistically significance differences between menopausal stages with regards to BMI, systolic and diastolic blood pressure, vitamin D deficiency, calcium deficiency and sheesha smoking habits. Overall, osteopenia and osteoporosis and bone loss were significantly lower in post-menopausal women than in menopausal women (P &lt; 0.001). Similarly, T-score and z-score were lower with depressed menopause and postmenopausal women (P &lt; 0.001).ConclusionThe multivariate logistic regression analyses revealed that the depression, the mean serum vitamin D deficiency, calcium level deficiency, less physical activity, co-morbidity, number of parity, systolic and diastolic blood pressure and sheesha smoking habits were considered as the main risk factors associated with bone mineral loss after adjusting for age, BMI and other variables.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

A Study of Hematological Biomarkers in Depressed Postmenopausal Females

Context: Due to the heterogeneity in the occurrence of depression in postmenopausal women and a lack of adequate data on correlation of severity of depression with the co-occurrence of thyroid, lipid and vitamin metabolism derangements in these women, this study was planned to examine the prevalence of these derangements and its correlation with severity of depression in depressed postmenopausal women. Aims: The aim of the study was to find out the prevalence and correlation of TSH, Lipid Profile, Folate and Vitamin B12 derangements with the severity of depression in postmenopausal women. Settings and design: A cross-sectional study was carried out at the Department of Psychiatry and Department of Obstetrics and Gynaecology, SMS Medical College, Jaipur. After screening 150 consecutive depressed postmenopausal females (age group of 45-60 years), 40 females and 40 healthy female controls, matched sociodemographic profile were included in the study. Materials and methods: After taking written informed consent, all subjects were assessed using Hamilton rating scale for depression, Menopausal rating scale and blood levels of TSH, lipid profile, folate and vitamin B12 was assessed. Statistical analysis used: Group comparisons were done with chi-square test, T-test and Pearson’s correlation, with help of SPSS, ver. 21.0. Results: There is significantly more prevalence and correlation of TSH and lipid profile derangements in depressed post-menopausal women, and the derangement in TSH levels worsens with the severity of depression. The folate levels are also significantly worse in the depressed group, but not Vitamin B12. Both did not correlate with severity of depression in the current study. Conclusion: Management of thyroid and lipid derangements can help manage depression in post-menopausal women more holistically. The role of folate and vitamin B12 replenishment can also be considered when judging treatment response in these patients.

Association of Age at Menopause and Duration of Reproductive Period With Depression After Menopause: A Systematic Review and Meta-analysis.

Estrogens have neuroprotective and antidepressive effects; however, associations between indices of reduced endogenous estrogens and risk for postmenopausal depression have not been systematically explored. To investigate the association of age at menopause and the duration of the reproductive period with the risk for depression among postmenopausal women with naturally occurring menopause. A search strategy for use of MEDLINE was developed (through January 1, 2015) using the key terms menopause, climacteric, reproductive period, depression, and mood disorders. References of included studies and reviews were also screened; authors were contacted to maximize synthesized evidence. A total of 12,323 articles, without language restriction, were screened by pairs of reviewers to identify observational studies related to the study hypothesis; 14 studies were eligible for meta-analysis. Pairs of reviewers independently extracted information on study design and type of analysis by participants' characteristics and methods of depression ascertainment. Study quality was assessed using the Newcastle-Ottawa Scale, and fixed- or random-effects models were implemented. Pooled-effect estimates for depression, defined by psychiatric evaluation or validated instruments, by age at menopause and duration of the reproductive period. The 14 studies included in the meta-analysis represented 67,714 women. An inverse association (reported as odds ratio [OR]; 95% CI of 2-year increments) with depression in postmenopausal women was shown for increasing age at menopause (0.98; 0.96-0.99 [67,434 unique participants; 13 studies]) and duration of the reproductive period (0.98; 0.96-0.99 [54,715 unique participants; 5 studies]). Menopause at age 40 or more years compared with premature menopause was associated with a 50% decreased risk for depression (3033 unique participants; 4 studies). Pooling of studies examining severe depression showed a 5% decrease in risk of severe depression with increasing (2-year increment) age at menopause (52,736 unique participants; 3 studies); sensitivity analysis of studies controlling for past depression revealed similar results for age at menopause (0.98; 0.96-1.00 [48,894 unique participants; 3 studies). No heterogeneity or publication bias was evident in the main analyses. Longer exposure to endogenous estrogens, expressed as older age at menopause and longer reproductive period, is associated with a lower risk of depression in later life. Identifying women at higher risk for depression due to early menopause who could benefit from psychiatric intervention or estrogen-based therapies could be useful in the clinical setting.