A substantial proportion of women transitioning into menopause experience a new onset or recurrence of depressive symptoms. A new study from the Center for Women’s Mental Health indicates that duloxetine (Cymbalta) is effective for the treatment of depression and may also have a beneficial effect on vasomotor symptoms (hot flashes and night sweats).
Aromatase inhibitors (AIs) are the preferred hormonal therapy for postmenopausal women with estrogen sensitive breast cancer. While the selective estrogen receptor modulators (SERMs), such as tamoxifen and raloxifene, are used in premenopausal women with estrogen sensitive breast cancer, the aromatase inhibitors (e.g., anastrozole, letrozole, and exemestane) have been shown to be more effective and safer than the SERMs in postmenopausal women.
Last summer, we posted a blog about using folate to treat (and perhaps prevent) depression in women of childbearing age. Supporting that recommendation are the several reports indicating that people with lower folate levels are at higher risk of major depression or may experience more severe depressive symptoms. Other studies have indicated that in folate-deficient patients, antidepressants may be less effective or may take longer to take effect.
While much research has demonstrated that maternal depression may negatively affect the child, leading to increased risk of developmental delays, behavioral problems, and psychiatric illness. Less research, however, has detailed the impact of paternal depression; several recent studies have focused on better understanding the risk factors for paternal depression and how paternal depression affects children.
Each year about 600,000 women in the United States undergo a hysterectomy. Somewhere between 55% and 80% of these women who also have their ovaries removed along with the uterus—a procedure known as oophorectomy. After the removal of the ovaries, menopause follows immediately and is associated with a constellation of symptoms including hot flashes and insomnia, as well as depression and anxiety.
Over the past few years, there has been a push to screen women for depression both during pregnancy and the postpartum period. While there have been various initiatives mandating screening, there remain questions regarding the optimal timing of screening and the best screening tools to use.
Recent reports suggest that people with lower folate levels are at higher risk of major depression or may experience more severe depressive symptoms. Other studies indicate that in folate deficient patients, antidepressants may be less effective or may take longer to take effect. In addition, some clinical trials have shown that folate may have a therapeutic effect on depression, either when taken alone or in combination with an antidepressant.
It is well established that women are at increased risk for developing depression compared to men. It has been hypothesized that this vulnerability to depression may be hormonally mediated, and several longitudinal studies have documented an increased risk of depressive symptoms during perimenopause or the menopausal transition. Based on the results of two prospective cohort studies, approximately one-third of women will develop their first episode of depression during the menopausal transition. (Cohen LS et al 2006, Freeman EW et al 2006).
Many women have concerns about the side effects of oral contraceptives (birth control pills). Potential side effects include bloating, breast tenderness, and weight gain. In addition, some women may experience depression or mood swings, side effects that may influence a woman’s decision to start taking a birth control pill, particularly if she has a history of depression.
