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更年期激素疗法能改善抑郁症状吗?来自一家专业更年期诊所的研究结果。

Does menopause hormone therapy improve symptoms of depression? Findings from a specialized menopause clinic.

作者信息

Gnanasegar Rahavi, Wolfman Wendy, Galan Leticia Hernandez, Cullimore Amie, Shea Alison K

机构信息

Mount Sinai Hospital, Toronto, ON, Canada.

From the The Research Institute of St. Joseph's Healthcare Hamilton, ON, Canada.

出版信息

Menopause. 2024 Apr 1;31(4):320-325. doi: 10.1097/GME.0000000000002325. Epub 2024 Feb 19.

Abstract

OBJECTIVE

Depressive symptoms are commonly reported during the perimenopause and in the early postmenopausal years. Although menopausal hormone therapy (MHT) is considered the most effective treatment option for vasomotor symptoms, its effect on mood-related symptoms is less established. This study aims to assess interval change in depressive symptoms after initiation of MHT treatment in women seeking care at a Canadian specialized menopause clinic.

METHODS

Women and female-presenting people attending the St. Joseph's Healthcare Menopause Clinic in Hamilton, Ontario, were invited to participate in this study. Participants (n = 170) completed a self-report questionnaire, which included their medical history as well as validated tools for bothersome symptoms at their initial visit. A shortened version was administered at the follow-up visit 3 to 12 months later with the same validated tools. We sought to examine interval changes on the Center for Epidemiological Studies Depression Scale based on type of treatment used and MHT dose, while controlling for relevant demographic variables (smoking, education level, age).

RESULTS

There was a high rate of depressive symptoms in those seeking specialized menopause care (62%). MHT use was associated with significantly improved depressive symptoms, both alone and in addition to an antidepressant medication ( P < 0.001). Younger age, lower education attainment, and smoking were all associated with higher depression scores.

CONCLUSION

This study supports the use of MHT to improve depressive symptoms experienced by those seeking specialized menopause care. Further investigation into timing of treatment initiation may facilitate a personalized treatment approach to improve quality of life of women in the peri- and postmenopausal years.

摘要

目的

围绝经期和绝经后早期经常出现抑郁症状。尽管绝经激素治疗(MHT)被认为是治疗血管舒缩症状最有效的方法,但其对情绪相关症状的影响尚不明确。本研究旨在评估在加拿大一家专业绝经诊所就诊的女性开始接受MHT治疗后抑郁症状的间隔变化。

方法

邀请安大略省汉密尔顿圣约瑟夫医疗中心绝经诊所的女性和表现为女性特征的人群参与本研究。参与者(n = 170)完成了一份自我报告问卷,其中包括她们的病史以及初诊时用于评估困扰症状的有效工具。在3至12个月后的随访中,使用相同的有效工具进行了一个简化版本的问卷调查。我们试图根据所使用的治疗类型和MHT剂量,同时控制相关人口统计学变量(吸烟、教育水平、年龄),来研究流行病学研究抑郁量表上的间隔变化。

结果

寻求专业绝经护理的人群中抑郁症状发生率很高(62%)。单独使用MHT以及与抗抑郁药物联合使用均与抑郁症状显著改善相关(P < 0.001)。年龄较小、教育程度较低和吸烟均与较高的抑郁评分相关。

结论

本研究支持使用MHT来改善寻求专业绝经护理者所经历的抑郁症状。对开始治疗时间的进一步研究可能有助于采取个性化治疗方法,以提高围绝经期和绝经后女性的生活质量。

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