Liang Gengfan, Kow Audrey Siew Foong, Yusof Rohana, Tham Chau Ling, Ho Yu-Cheng, Lee Ming Tatt
Faculty of Pharmaceutical Sciences, UCSI University, Kuala Lumpur 56000, Malaysia.
Faculty of Applied Sciences, UCSI University, Kuala Lumpur 56000, Malaysia.
Biomedicines. 2024 Jan 15;12(1):184. doi: 10.3390/biomedicines12010184.
Perimenopausal depression, occurring shortly before or after menopause, is characterized by symptoms such as emotional depression, anxiety, and stress, often accompanied by endocrine dysfunction, particularly hypogonadism and senescence. Current treatments for perimenopausal depression primarily provide symptomatic relief but often come with undesirable side effects. The development of agents targeting the specific pathologies of perimenopausal depression has been relatively slow. The erratic fluctuations in estrogen and progesterone levels during the perimenopausal stage expose women to the risk of developing perimenopausal-associated depression. These hormonal changes trigger the production of proinflammatory mediators and induce oxidative stress, leading to progressive neuronal damage. This review serves as a comprehensive overview of the underlying mechanisms contributing to perimenopausal depression. It aims to shed light on the complex relationship between perimenopausal hormones, neurotransmitters, brain-derived neurotrophic factors, chronic inflammation, oxidative stress, and perimenopausal depression. By summarizing the intricate interplay between hormonal fluctuations, neurotransmitter activity, brain-derived neurotrophic factors, chronic inflammation, oxidative stress, and perimenopausal depression, this review aims to stimulate further research in this field. The hope is that an increased understanding of these mechanisms will pave the way for the development of more effective therapeutic targets, ultimately reducing the risk of depression during the menopausal stage for the betterment of psychological wellbeing.
围绝经期抑郁症发生在绝经前后不久，其特征是出现情绪低落、焦虑和压力等症状，常伴有内分泌功能障碍，尤其是性腺功能减退和衰老。目前治疗围绝经期抑郁症的方法主要是缓解症状，但往往伴有不良副作用。针对围绝经期抑郁症特定病理机制的药物研发进展相对缓慢。围绝经期雌激素和孕激素水平的不稳定波动使女性面临患围绝经期相关抑郁症的风险。这些激素变化会引发促炎介质的产生并诱导氧化应激，导致神经元进行性损伤。本综述全面概述了导致围绝经期抑郁症的潜在机制。它旨在阐明围绝经期激素、神经递质、脑源性神经营养因子、慢性炎症、氧化应激与围绝经期抑郁症之间的复杂关系。通过总结激素波动、神经递质活性、脑源性神经营养因子、慢性炎症、氧化应激与围绝经期抑郁症之间的复杂相互作用，本综述旨在激发该领域的进一步研究。希望对这些机制的深入了解将为开发更有效的治疗靶点铺平道路，最终降低绝经阶段抑郁症的风险，改善心理健康。
