Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.
Department of Psychiatry, Central Clinical School, Monash University, Melbourne, VIC, Australia.
Drugs Aging. 2022 Aug;39(8):607-618. doi: 10.1007/s40266-022-00962-x. Epub 2022 Jul 30.
Perimenopause marks the transition from a woman's reproductive stage to menopause. Usually occurring between 42 and 52 years of age, it is determined clinically by the onset of irregular menstrual cycles or variable cycle lengths. Women are at an increased risk of depression and anxiety during perimenopause and the menopausal transition. Depressive symptoms experienced in perimenopause are often more severe compared to pre- and post-menopause. During menopausal transition, the impact of fluctuating estrogen in the central nervous system (CNS) can have negative psychological effects for some women. Traditional first-line management of menopausal depression involves antidepressants, with modest outcomes. The positive effects of estrogen treatment in the CNS are becoming increasingly recognised, and hormonal therapy (HT) with estrogen may have a role in the treatment of menopausal depression. In this review we will outline the prevalence, impact and neurochemical basis of menopausal-associated depression, as well as hormone-based approaches that have increasing promise as effective treatments.
围绝经期标志着女性从生育期向绝经期的过渡。通常发生在 42 岁至 52 岁之间,临床上通过月经周期不规律或周期长度变化来确定。在围绝经期和绝经过渡期间,女性患抑郁症和焦虑症的风险增加。与绝经前和绝经后相比,围绝经期的抑郁症状往往更严重。在绝经过渡期间,中枢神经系统 (CNS) 中雌激素波动的影响可能对一些女性产生负面心理影响。绝经期抑郁症的传统一线治疗方法包括使用抗抑郁药,但效果并不显著。雌激素对中枢神经系统的积极作用越来越受到认可,雌激素激素治疗 (HT) 可能在治疗绝经期抑郁症方面发挥作用。在这篇综述中,我们将概述与绝经相关的抑郁症的流行率、影响和神经化学基础,以及作为有效治疗方法的基于激素的方法。