important menopause information
Decreasing hormone levels in the perimenopause and menopause can cause the physical symptoms of hot flashes, night sweats and vaginal dryness, but are also related to symptoms of anxiety and depression. Some women are very sensitive to hormonal changes manifested in PMS, pregnancy, postpartum, and during the menopausal transition.
Depressive symptoms include sadness, anxiety, fatigue, lack of energy, sleep disorders such as difficulty falling and staying asleep, and changes in appetite. More serious symptoms of hopelessness, worthlessness and suicidal ideation can occur. When depressive symptoms result in alterations of daily life and activities, it may be diagnosed as a clinical depression. The onset of clinical depression can occur at menopause.
Symptoms of menopause can include hot flashes, night sweats, sleep disturbances, weight gain, fatigue, decreased memory, and sexual dysfunction, and these symptoms can overlap with those of depression and anxiety, which is one reason why the diagnosis may be more difficult. This is often a time when women experience difficult life changes such as children leaving home, parents aging, job stresses and relationship issues which add difficult social components to the equation.
If you have suffered from depression in the past, have experienced PMS or postpartum depression, you are especially vulnerable during this time. If mood changes affect your ability to attend to normal daily activities, you should be appropriately evaluated and treated. Don’t be reluctant to recognize symptoms and ask for help.
So how do you treat depressive symptoms of menopause and clinical depression?
If diagnosed with clinical depression, certain antidepressants are effective in treating the mood disorder as well as vasomotor symptoms of hot flashes and night sweats. Gabapentin used at bedtime can alleviate night sweats and improve sleep. Cognitive behavioral therapy and psychotherapy can also be helpful in conjunction with medications.
Although hormone replacement therapy is not approved to treat mood disorders, research indicates that estrogen may be as effective as antidepressants in perimenopausal women, even if they are not experiencing hot flashes. Estrogen can benefit mood and well being in women who do not suffer depression. In postmenopausal women, estrogen is not effective in treating depression. There is less information about hormonal combinations such as estrogen and testosterone.
There is little data to support the use of complementary medical treatments such as herbal remedies or supplements to treat depression in menopause. Exercise may be helpful in alleviating depressive symptoms.
As with all medical decisions, your individual symptoms and medical history must be taken into account to decide on which treatment is best for your situation.
MenoNote, MenoNotes Task Force of the North American Menopause Society,