An estimated 80% of sexually active young women in the United States use hormonal or oral contraceptives (OCs). Clinically it is found that some women report depression or mood swings with oral contraceptives; however, many women seem to tolerate hormonal contraceptive without any effects on mood. Despite the prevalence of OC usage, few studies have explored the association between hormonal contraceptive use and mood disturbance.
The US Food and Drug Administration (FDA) has approved a novel estrogen-based drug for women for the treatment of moderate-to-severe vasomotor symptoms and osteoporosis associated with menopause. Duavee (Wyeth Pharmaceuticals) is a once-a-day tablet containing a combination of conjugated estrogens and bazedoxifene, an estrogen agonist/antagonist.
Several recent studies have examined the impact of various types of physical activity on menopausal symptoms, including hot flashes, night sweats, and sleep disturbance.
In an excellent and thoughtful review article, Kristina Deligiannidis and Marlene Freeman (from the MGH Center for Women’s Mental Health) summarize data on the efficacy of complementary and alternative medicine therapies for the treatment of perinatal depression. This is one of the most thorough reviews on CAM and provides thoughtful, evidence-based recommendations regarding the use of these treatments for women with perinatal depression. It is definitely worth tracking down a copy of this review, but if you can’t find it, here is a summary.
Pregnancy loss may cause great psychological stress for women. How such a loss, whether or not the woman identifies it as a stressor, affects her emotional well-being after the birth of a future child is unknown. In order to better understand the relationship between pregnancy loss and risk for postpartum psychiatric illness, researchers assessed 192 women at their first-year pediatric well-child care visits in an urban pediatric clinic. In this group of low income mothers, 49% of the women reported a previous pregnancy loss (miscarriage, stillbirth, or induced abortion).
Eating disorders are relatively common among women of reproductive age, yet the literature on the effects of maternal eating disorders (ED) on pregnancy outcomes is relatively sparse. There has been concern that eating disorders may negatively affect gestational weight gain. Previous studies have demonstrated an association between maternal anorexia nervosa (AN) (both active and past) and lower infant birthweight (as compared to women with no history of ED); however, calculations of the magnitude of this effect have been inconsistent.Â
Various screening tools have been used to identify women with postpartum depression (PPD. The most widely used self-report tools for detection of PPD are the Edinburgh Postnatal Depression Scale (EPDS) and the Beck Depression Inventory (BDI) having ten and 21 items, respectively. However, the EPDS and the BDI may be too lengthy to use for quickly screening patients in obstetric, primary care, or pediatric settings.
About 75% of women with regular menstrual cycles report unpleasant physical or psychological symptoms premenstrually. For the majority of women, these symptoms are mild and tolerable. However, some women have more severe and disabling symptoms, or premenstrual dysphoric disorder (PMDD). Several years ago, a large, multicenter trial of calcium supplementation found that calcium (600 mg twice a day) significantly reduced both the physical and emotional symptoms of PMS; however, it has not been clear whether calcium supplementation might be effective for more severe premenstrual symptoms or PMDD.
Approximately seventy percent of all women experience hot flashes and/or night sweats during the menopause transition (Stearns et al, 2002). Until recently, estrogen therapy was the treatment of choice for most women who sought treatment for hot flashes, but today many women are pursuing non-hormonal treatments, including over-the-counter complementary and alternative medicines (CAMs) for the treatment of these symptoms.Â
Women with premenstrual symptoms (PMS) and premenstrual dysphoric disorder experience symptoms during the premenstrual phase of their cycles.  Because levels of estrogen and progesterone do not differ significantly between women with PMS and those without, it has long been hypothesized that PMS/PMDD represents an abnormal response to normal hormonal fluctuations (Schmidt et al, 1998).
