Looking through the window: depression and menopause

Posted by on Dec 27, 2010 in depression | 2 comments

There’s a new term that’s being kicked around in medical circles: ‘windows of vulnerability.’

It appears that a growing body of evidence supports the fact that during times of hormonal flux or reproductive cycle “events,” women become increasingly vulnerable to mood swings, anxiety and depression. And while this is certainly not news for many women, it still requires some attention because among the many windows that women may go through, the menopausal transition is evidently one of the most complex. The reason? This is a time when hormones interact with aging, sexuality, life stressors, self-esteem and general health issues.

The subject of depression and menopause is not new to this blog, nor are statistics suggesting that as many as 20% to 40% of women are believed to suffer major depression or at the very least, depressive symptoms during the peri/postmenopausal years. Moreover, women may have as much as a two- to four-times increased risk of developing depression as they transition from pre- to perimenopausal status. Among the multiple factors at play, estrogen is one of the most important; estrogen has been shown to promote the amount of the mood neurotransmitter serotonin available to the body, thereby providing an important antidepressant effect. However, a recent review suggests that the role that hormones like estrogen play in depression is directly related to their wide fluctuations rather than the fact that they are becoming deficient.

So, why is this important? For one, it highlights that hormone replacement is not the only answer for depression during menopause but rather, that it’s critical to pay attention to timing, i.e. when preventive strategies, including exercise, behavioral therapy and antidepressants might yield the greatest long-term benefits. Yet, it also suggests that estrogen-based therapies may indeed have a role in depression during menopause. And, since estrogen alone therapy has been shown to up the risk for ovarian cancer except for in women who’ve had hysterectomies, it also helps supports the need to explore the role plant-based estrogens in treating menopausal depression; fortunately, S-equol has already shown promise in this regard.

Feeling the window of vulnerability? There’s no time like the present to insure that you aren’t simply looking through the window but actually seeing that there’s hope and help on the other side. There are a lot of resources and strategies available to address depression during this time of life. While depression may be a “menopause-associated risk,” like others, it can be successfully ameliorated.

 

Thank you to Dr. Claudio Soares from McMaster University for an excellent review of depression in menopause and the inspiring, succinct “windows of vulnerability” terminology.

2 Comments

  1. 12-27-2010

    Liz,
    This is great. I think the perfectly named “Window of Vulnerability” turns into a losing the side of the house when peri-menopausal women are hit with chemo- than tamoxifen. That was a difficult time of my life I’m so glad is over.

    I’m with you 150% on encouraging women – and all female cancer survivors – to embrace those things we CAN do to aid health and well-being. Even though it’s far from easy, it builds both esteem and health without any of the risks associated with taking a pill.

    Happy New Year and thank you for your great work in unraveling the mysteries of hormones.

    Jody

  2. 12-27-2010

    Jody. It is indeed, aptly named and I am happy to both have discovered it and shared it with you all. It’s an interesting challenge that you’ve identified – take the perimenopausal situation and then compound it with chemo; yet another factor thrown into the mix. Ultimately, by gaining a better understanding of what we can and cannot control, we will then be in a better position to take actions that lessen the pain so to speak, and make us healthier on multiple levels. Thank you for your continued support and for the consistent dialogue. Best to you for the New Year!

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