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Perimenopause and Mood Disturbance: An Update

Published online by Cambridge University Press:  07 November 2014

Cláudio N. Soares  and
Lee S. Cohen
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Abstract

This review characterizes perimenopause, including biologic changes, the influence of psychosocial factors, and the most common clinical manifestations. Clinic-based studies and community-based surveys addressing the prevalence of depressive symptoms in perimenopausal women are critically reviewed. Also discussed is the potentially greater vulnerability to mood disturbance during perimenopause in response to hormonal variability. A therapeutic algorithm for management of depressive symptoms in middle-aged perimenopausal women is presented. The role of estrogen in the treatment of perimenopausal depressive symptoms is addressed. In addition, the article contains a review of the existing data on the potential efficacy of estrogen as an antidepressant agent (monotherapy, augmentation strategy, or prophylaxis).

Type
Feature Articles
Information
CNS Spectrums , Volume 6 , Issue 2: Female-Specific Mood Disorders , February 2001 , pp. 167 - 174
Copyright
Copyright © Cambridge University Press 2001

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References

REFERENCES

1.World Health Organization. Research on menopause in the 1990s: report of a WHO scientific group. World Health Organ Tech Rep Ser. 866, Geneva, Switzerland, 1996.Google Scholar
2.Teede, H. Burger, HG. The menopausal transition. In: Studd, JWW, ed. The Management of Menopause—Annual Book Review. London, England: Parthenon; 1998:1–12.Google Scholar
3.Schmidt, PJ, Roca, CA, Bloch, M, et al.The perimenopause and affective disorders. Semin Reprod Endocrinol. 1997;15:91–100.CrossRefGoogle ScholarPubMed
4.The North American Menopause Society. Clinical challenges ol perimenopause: Consensus opinion of the North American Menopause Society. Menopause. 2000;7:5–13.CrossRefGoogle Scholar
5.Treloar, AE. Menstrual cyclicily and (the premenopause. Maturitas. 1981;3:249–264.CrossRefGoogle ScholarPubMed
6.McKinlay, SM. The normal menopause transition: an overview. Maturitas. 1996;23:137–145.CrossRefGoogle ScholarPubMed
7.Midgette, AS, Baron, JA. Cigarette smoking and the risk of natural menopause. Epidemiology. 1990;1:474–480.CrossRefGoogle ScholarPubMed
8.Speroff, L. The menopause: a signal for the future. In: Lobo, RA, ed. Treatment of Post-menopausal Women. New York, NY: Raven Press; 1994:1–10.Google Scholar
9.Harlow, BL, Cramer, DW, Annis, KM. Association of medically treated depression and age at natural menopause. Am J Epidemiol. 1995;141:1170–1176.CrossRefGoogle ScholarPubMed
10.Metcalf, MG, Donald, RA. Fluctuating ovarian function in perimenopausal women. N J Med J. 1979;89:45–47.Google ScholarPubMed
11.McKinlay, SM, Jeffreys, M. The menopausal syndrome. Br J Prev Soc Med. 1974;28:108–115.Google ScholarPubMed
12.Swartzman, LC, Edelherg, R, Kemmann, E. The menopausal hot flush: symptom reports and concomitant physiological changes. J Behav Med. 1990;13:15–30.CrossRefGoogle ScholarPubMed
13.Freedman, RR. Hot flashes revisited. Menopause. 2000;7:3–4.Google ScholarPubMed
14.Kronenberg, F. Hot Hashes: phenomenology, quality of life, and search for treatment options. Exp Gerontol. 1994;29:319–336.CrossRefGoogle Scholar
15.Campbell, S, Whitehead, M. Oestrogen therapy and the menopausal syndrome. Clin Obstet Gynaecol. 1977;4:31–47.CrossRefGoogle ScholarPubMed
16.Haas, S, Walsh, B, Evans, S, et al.The effect of transdermal estradiol on hormone and metabolic dynamics over a six-week period. Obstet Gynecol. 1988;71:671–676.Google Scholar
17.Guthrie, JR, Dennerstein, L, Hopper, JL, et al.Hot flushes, menstrual status, and hormone levels in a population-based sample of midlife women. Obstet Gynecol. 1996;88:437–442.CrossRefGoogle Scholar
18.Mitchell, ES, Woods, NF. Symptom experiences of midlife women: observations from the Seattle Midlife Women's Health Study. Maturitas. 1996;25:1–10.CrossRefGoogle ScholarPubMed
19.Jaszmann, L, Van Lith, ND, Zaat, JC. The age of menopause in the Netherlands. The statistical analysis of a survey. Int J Fertil. 1969;14:106–117.Google Scholar
20.Baram, DA. Physiology and symptoms of menopause. In: Stewart, DE, Robinson, GE, eds. A Clinicians Guide to Menopause. Washington, DC: American Psychiatric Press; 1997:9–27.Google Scholar
21.Woods, NF. Menopause, Models, Medicine and Midlife. San Francisco, Calif: North American Menopause Society; 1995.Google Scholar
22.Bart, PB, Grossman, M. Menopause. In: Notman, MT, Nadelson, CC. eds. The Woman Patient. New York, NY: Plenum; 1978:337–354.CrossRefGoogle Scholar
23.Glenn, ND. Psychological well-being in the post-parental stage: some evidence from national surveys. J Marital Fam Ther. 1975;32:105–110.Google Scholar
24.Lock, M. Ambiguities of aging: Japanese experience and perceptions of menopause. Cult Med Psychiatry. 1986;10:23–46.CrossRefGoogle ScholarPubMed
25.Lock, M. Menopause in cultural context. Exp Gerontol. 1994;29:307–317.CrossRefGoogle ScholarPubMed
26.Nagata, C, Takatsuka, N, Inaba, S, et al.Association of diet and other lifestyle with onset of menopause in Japanese women. Maturitas. 1998;29:105–113.CrossRefGoogle ScholarPubMed
27.Anderson, E, Hamburger, S, Liu, JH, et al.Characteristics of menopausal women seeking assistance. Am J Obstet Gynecol. 1987;156:428–433.CrossRefGoogle ScholarPubMed
28.Hay, AC, Bancroft, J, Johnstone, EC. Affective symptoms in women attending a menopause clinic. Br J Psychiatry. 1994;164:513–516.CrossRefGoogle ScholarPubMed
29.Novaes, C, Almeida, OP. Premenstrual syndrome and psychiatric morbidity at the menopause. J Psychosom Obstet Gynaecol. 1999;20:56–57.CrossRefGoogle ScholarPubMed
30.Morse, CA, Smith, A, Dennerstein, L, et al.The treatment-seeking woman at menopause. Maturitas. 1994;18:161–173.CrossRefGoogle ScholarPubMed
31.Avis, NE, McKinlay, SM. A longitudinal analysis of women's attitudes toward the menopause: results from the Massachusetts Women's Health Study. Maturitas. 1991;13:65–79.CrossRefGoogle ScholarPubMed
32.Burt, VK, Altshuler, LL, Rasgon, N. Depressive symptoms in the perimenopause: prevalence, assessment, and guidelines for treatment. Harv Rev Psychiatry. 1998;6:121–132.CrossRefGoogle ScholarPubMed
33.Bungay, GT, Vessey, MP, McPherson, CK. Study of symptoms in middle life with special reference to the menopause. Br Med J. 1980;281:181–183.CrossRefGoogle Scholar
34.Novaes, C, Almeida, OP, de Melo, NR. Mental health among perimenopausal women attending a menopause clinic: possible association with premenstrual clinic? Climacteric. 1998;1:264–270.CrossRefGoogle ScholarPubMed
35.Ballinger, CB. Psychiatric morbidity and the menopause: survey of a gynaecological outpatient clinic. Br J Psychiatry. 1977;131:83–89.CrossRefGoogle Scholar
36.Hunter, M, Battersby, R, Whitehead, M. Relationships between psychological symptoms, somatic complaints and menopausal status. Maturitas. 1986;8:217–228.CrossRefGoogle ScholarPubMed
37.Collins, A, Landgren, BM. Reproductive health, use of estrogen and experience of symptoms in perimenopausal women: a population-based study. Maturitas. 1994;20:101–111.CrossRefGoogle ScholarPubMed
38.Kaufert, PA, Gilbert, P, Tate, R. The Manitoba Project: a re-examination of the link between menopause and depression. Maturitas. 1992;14:143–155.CrossRefGoogle Scholar
39.Harlow, BL, Cohen, LS, Otto, MW, et al.Prevalence and predictors of depressive symptoms in older premenopausal women: the Harvard Study of Moods and Cycles. Arch Gen Psychiatry. 1999;56:418–424.CrossRefGoogle Scholar
40.Schmidt, PJ, Rubinow, DR. Menopause-related affective disorders: a justification for further study. Am J Psychiatry. 1991;148:844–852.Google ScholarPubMed
41.Arpels, JC. The female brain hypoestrogenic continuum from the premenstrual syndrome to menopause. A hypothesis and review of supporting data. J Reprod Med. 1996;41:633–639.Google ScholarPubMed
42.Studd, J. Oestrogens and depression in women. Br J Hosp Med. 1992;48:211–213.Google ScholarPubMed
43.Schmidt, PJ, Nieman, LK, Danaceau, MA, et al.Differential behavioral effects of gonadal steroids in women with and in those without premenstrual syndrome. N Engl J Med. 1998;338:209–216.CrossRefGoogle ScholarPubMed
44.Joffe, H, Cohen, LS. Estrogen, serotonin, and mood disturbance: where is the therapeutic bridge? Biol Psychiatry. 1998;44:798–811.CrossRefGoogle ScholarPubMed
45.Kessler, RC, McGonagle, KA, Swartz, M, et al.Sex and depression in the National Comorbidity Survey. I: Lifetime prevalence, chronicity and recurrence. J Affect Disord. 1993;29:85–96.CrossRefGoogle ScholarPubMed
46.Morse, CA, Dudley, E, Guthrie, J, et al.Relationships between premenstrual complaints and perimenopausal experiences. J Psychosom Obstet Gynaecol. 1998;19:182–191.CrossRefGoogle ScholarPubMed
47.Larsson, C, Hallman, J. Is severity of premenstrual symptoms related to illness in the climacteric? J Psychosom Obstet Gynaecol. 1997;18:234–243.CrossRefGoogle ScholarPubMed
48.Roca, CA, Schmidt, PJ, Rubinow, DR. Mood, Hormones and Menopause. Syllabus and Proceedings Summary of the 153rd American Psychiatric Association Annual Meeting; May 14, 2000; Chicago, Ill.Google Scholar
49.Guicheney, P, Leger, D, Barrat, J, et al.Platelet serotonin content and plasma tryptophan in peri- and postmenopausal women: variations with plasma oestrogen levels and depressive symptoms. Eur J Clin Invest. 1988;18:297–304.CrossRefGoogle ScholarPubMed
50.Holte, A. Menopause, mood and hormone replacement therapy: methódological issues. Maturitas. 1998;29:5–18.CrossRefGoogle ScholarPubMed
51.Stearns, V, Isaacs, C, Rowland, J, et al.A pilot trial assessing the efficacy of paroxetine hydrochloride (Paxil) in controlling hot flashes in breast cancer survivors. Ann Oncol. 2000;11:17–22.CrossRefGoogle ScholarPubMed
52.Soares, CN, Almeida, OP. Association between depression during perimenopause and serum levels of follicle-stimulating hormone (FSH) and estradiol (E2) [in Portuguese]. Rev Bras Psiquiat. 2000;22:17–21.CrossRefGoogle Scholar
53.Sarrel, PM. Sexuality and menopause. Obstet Gynecol. 1990;75(suppl):26S–30S.CrossRefGoogle ScholarPubMed
54.Jensen, J, Nilas, L, Christiansen, C. Influence of menopause on serum lipids and lipoproteins. Maturitas. 1990;12:321–331.CrossRefGoogle ScholarPubMed
55.Tang, MX, Jacobs, D, Stern, Y, et al.Effect of oestrogen during menopause on risk and age at onset of Alzheimer's disease. Lancet. 1996;348:429–432.CrossRefGoogle ScholarPubMed
56.Smith, RN, Studd, JW, Zamblera, D, et al.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;102:475–484.CrossRefGoogle ScholarPubMed
57.Gregoire, AJP, Kumar, R, Everitt, B, et al.Transdermal oestrogen for treatment of severe postnatal depression. Lancet. 1996;347:930–933.CrossRefGoogle ScholarPubMed
58.Wiklund, I, Berg, G, Hammar, M, et al.Long-term effect of transdermal hormonal therapy on aspects of quality of life in postmenopausal women. Maturitas. 1992;14:225–236.CrossRefGoogle Scholar
59.Karlberg, J, Mattsson, LA, Wiklund, I. A quality of life perspective on who benefits from estradiol replacement therapy. Acta Obstet Gynecol Scand. 1995;74:367–372.CrossRefGoogle ScholarPubMed
60.Schneider, MA, Brotherton, PL, Hailes, J. The effect of exogenous oestrogens on depression in menopausal women. Med J Aust. 1977;2:162–163.CrossRefGoogle ScholarPubMed
61.Pearce, J, Hawton, K, Blake, F, et al.Psychological effects of continuation versus discontinuation of hormone replacement therapy by estrogen implants: a placebo-controlled study. J Psychosom Res. 1997;42:177–186.CrossRefGoogle ScholarPubMed
62.Coope, J. Is oestrogen therapy effective in the treatment of menopausal depression? J R Coll Gen Pract. 1981;31:134–140.Google ScholarPubMed
63.Thomson, J. Double blind study on the effect of estrogen on sleep, anxiety and depression in perimenopausal women: preliminary results. Proc R Soc Med. 1976;69:829–830.Google ScholarPubMed
64.Schmidt, PJ, Nieman, L, Danaceau, MA, et al.Estrogen replacement in perimenopause-related depression: a preliminary report. Am J Obstet Gynecol. 2000;183:414–420.CrossRefGoogle ScholarPubMed
65.Soares, CN, Almeida, OP, Joffe, H, et al.Efficacy of estradiol for the treatment of depressive disorders in perimenopausal women: a double-blind, randomized, placebo-controlled trial. Arch Gen Psychiatry. 2001. In press.Google Scholar
66.Strickler, RC, Borth, R, Cecutti, A, et al.The role of oestrogen replacement in the climacteric syndrome. Psychol Med. 1977;7:631–639.Google ScholarPubMed
67.Shapira, B, Oppenheim, G, Zohar, J. Lack of efficacy of estrogen supplementation to imipramine in resistant female depressives. Biol Psychiatry. 1985;20:576–579.CrossRefGoogle ScholarPubMed
68.Schneider, LS, Small, GW, Hamilton, SH, et al.Estrogen replacement and response to fluoxetine in a multicenter geriatric depression trial. Am J Geriatr Psychiatry. 1997;5:97–106.CrossRefGoogle Scholar
69.Amsterdam, J, Garcia-Espana, F, Fawcett, J, et al.Fluoxetine efficacy in menopausal women with and without estrogen replacement. J Affect Disord. 1999;55:11–17.CrossRefGoogle ScholarPubMed
70.Sichel, DA, Cohen, LS, Robertson, LM, et al.Prophylactic estrogen in recurrent postpartum affective disorder. Biol Psychiatry. 1995;38:814–818.CrossRefGoogle ScholarPubMed