Study linking data from the Danish national population and health registries found that women who were prescribed oral hormone therapy were more likely than those who weren’t to get a hospitalization. Depression soon afterward.
Researchers reportedWomen between the ages of 45-50 years were at highest risk. The association decreased gradually over time.
However, international experts outside the study are speaking up about the limitations of population studies like this – which cast into stark relief how little is known about menopause and depression – especially when hormone therapies It can be very effectiveSome women may experience perimenopausal depression.
“Many women begin taking hormone therapy precisely because of negative changes in their mood – which fits with the report that the incidence of depression was greatest after initiation and then gradually declined,” “Neuroscientist Ciara McCabe, University of Reading
This type of study cannot distinguish between mood changes due to depression and medication changes. It also can’t look at the factors that precipitated the use hormone therapy.
This is not a randomised controlled trial. It’s not possible to know if the factors that lead to hormone therapy were related to the results of interest.” “Matt Sydes from the UK Medical Research Council Clinical TrialUnit in London
Jayashri Kulkarni, a Monash University psychiatrist in Australia who is an expert on perimenopausal depressive disorder, expressed concern that large-scale population studies like these could be misinterpreted by women or their clinicians. This could lead to worse outcomes for women already suffering from menopausal symptoms and in need of hormone treatment.
As a result of confusion about women’s health, there has been a dramatic drop in hormonal prescriptions This has happened beforeThis was the case in the 2000s. Kulkarni said that many women have suffered because of this. ScienceAlert.
Being a retrospective observational study, there is an awful lot the Danish dataset does not capture – which serves as a good reminder of the limitations of these kinds of epidemiology studies, so let’s take a look.
Kulkani states that the study lumps together all estrogen hormone therapies, when, for instance, some estrogens designed to treat menopausal hot flashes don’t reach the brain and would have very little effect on mood.
Changing levels of hormones in the brain affect mood, and menopause hormone medications – containing synthetic versions of sex hormones, estrogen, and progesterone, either alone or in combination – work to stabilize those fluctuations.
Also, the study only included data about hospitalized depression cases. It did not capture the personal histories of women who experienced depression.
“It does not consider the very important nuances of the diagnosis of depression … nor does it consider the large variation in the forms of hormone treatments or the frequent fluctuations in mental health due to menopause,” Kulkarni told ScienceAlert.
ScienceAlert was alerted by Kalkani that the diagnosis of depression has significantly changed in the 20-year period covered by the study, which spans 1995 to 2017.
Many new hormones for menopause have been developed and are still being developed. “.
Depression can also be a spectrum condition. It is a condition that is linked to life events and responds differently.
“Women can have many different symptoms and experiences. [after their diagnosis]What the causalities are. Many women say that trauma is the main cause of depression.
Kulkarni argues that these types of retrospective studies, which probe decades-old data, are not the type research needed to advance the field.
It’s Clinical trialsKulkani describes how they carefully diagnose and monitor women as they receive treatment. They also include neuroscience studies that examine hormones’ effects on the brain. This will improve our understanding of the causes and best treatments for women.
“Research in this area is desperately needed – but what is really needed is a big, prospective detailed Clinical trial“, comparing hormone therapy to antidepressants.
This is the bigger issue that could be overlooked. Women’s health, especially during menopause, has been terribly neglected. A large majority of depression sufferers are also depressed. Aren’t receiving the best treatmentThey have to.
As Kulkarni WritesIn the recent Nature Outlook Perspective: Obtaining a diagnosis for depression can be difficult for women due to the misunderstanding of depression in women.
This is an indication of systemic sexism. pervades biomedical researchThis in turn, affects the care that women receive, she said.
“Many doctors do not recognize that hormone therapy is a cause of midlife depression in women who are experiencing it. Writes Kulkarni.
“A large part of the reluctance of clinicians to prescribe is due to their reluctance.” [hormone therapy] for menopausal depression is the lack of knowledge about menopause – particularly how it affects the brain.”
Some women, trans people and non-binary persons may experience depression for the first time during menopause. Other people who have had a history with depression might experience a resurgence in depressive symptoms during menopause.
In either case, the prevalence of depression is high Peaks in the years surrounding menopause. Suicide rates, too. Perimenopause depression can also be a problem. Diagnosed years laterIf possible,
The fact that menopause symptoms can also include mood changes and other psychological symptoms is complicating matters. Maximum five years.
Clearly, far more research is needed to delve into the complexities of menopause and depression – and much more funding is needed to make that research a reality.
The study was published by JAMA Network Open.
