Freeman Ellen W
Department of Obstetrics/Gynecology and Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3701 Market Street, Suite 820 (Mudd Suite), Philadelphia, PA 19104 USA.
Womens Midlife Health. 2015 Aug 11;1:2. doi: 10.1186/s40695-015-0002-y. eCollection 2015.
There is accumulating evidence but no definitive answers about the incidence of depressed mood in the menopause transition and its association with the changing hormonal milieu. While a changing hormonal milieu is the natural condition for all women, only a minority of mid-life women experience debilitating depressive symptoms or clinical depression. This review focuses on associations between depressed mood and the menopause transition, primarily as identified in longitudinal, population-based studies in the past decade. Further aims were to present reported associations between depressed mood and reproductive hormones in the menopause transition as evaluated in the general population and associations of depressive symptoms or clinical depression with menopausal hot flashes or poor sleep in perimenopausal women. There is evidence to support the role of the changing endocrine milieu in the development of depressed mood in the menopause transition, but the contribution of hormones as measured is small. Disentangling the numerous factors that are associated with depression in midlife women is a major challenge for research and for clinical care, where treatments are needed to improve the most distressing menopausal symptoms.
关于绝经过渡期间抑郁情绪的发生率及其与激素环境变化的关联，有越来越多的证据，但尚无定论。虽然激素环境变化是所有女性的自然状态，但只有少数中年女性会经历使人衰弱的抑郁症状或临床抑郁症。本综述主要关注过去十年中基于人群的纵向研究中所确定的抑郁情绪与绝经过渡之间的关联。进一步的目的是呈现普通人群中评估的绝经过渡期间抑郁情绪与生殖激素之间的报道关联，以及围绝经期女性中抑郁症状或临床抑郁症与潮热或睡眠不佳之间的关联。有证据支持内分泌环境变化在绝经过渡期间抑郁情绪发展中的作用，但所测量的激素贡献较小。理清与中年女性抑郁症相关的众多因素，对研究和临床护理而言都是一项重大挑战，临床护理中需要采取治疗措施来改善最令人苦恼的绝经症状。
