2024-09-24 13:14:46
With the onset of menopause, women experience strong hormonal changes: for a third, the stress is great, and some of those affected even experience depression or develop depression. But severe symptoms can be prevented.
A team led by Arianna Di Florio from Cardiff University in England recently described a direct connection. The study is in the journal “Nature Mental Health”. lead tofound that the likelihood of having a major depressive episode for the first time in life increased by around 30 percent during the period.
Researchers compared data from British women over a four-year period around their last menstrual period with data from women six to 10 years before their last period. Results: Of nearly 40,000 women in perimenopause, around 700 develop depression for the first time. Of the same number of women observed at a slightly older age, there are only around 550.
Experts say further research could help predict an individual’s risk of mental health problems during perimenopause – this could be “life saving”. Because the signs of depression and perimenopause are similar, sometimes it is difficult to clearly show the symptoms – and to treat them, explains Markus Banger, medical director and senior physician in the department for dependency disorders and psychotherapy at the LVR Hospital in Bonn.
In any case, menopause progresses very differently. “Almost one in three women are no different during menopause than before,” write Federal Agency for Health Education (BZgA). Other third-level experiences include annoying but not severe symptoms. “A third also reported symptoms following severe stress.”
Possible symptoms of perimenopause, such as sleep disorders, concentration problems and depressive moods, develop gradually and gradually, says Katrin Schaudig, psychologist and president of the Clinic. German Menopause Society. “Since they occur every now and then in women’s lives, those affected often do not even think about menopause at first and endure the symptoms for a long time – and therefore even more stressful.”
Hormonal rollercoaster ride
The beginning of perimenopause in particular is often not well recognized or understood, explains the gynecologist. Perimenopause doesn’t begin at a certain age, but rather when the egg supply is coming to an end: Generally, it begins between the ages of 40 and mid-40s, but it may not start until the age of 50, say experts. .
The cause of the symptoms is a strong hormonal “ebb and flow”: With the egg supply decreasing, the control of the menstrual cycle becomes disturbed, as the diencephalon tries “with all its power” to maintain the development of the egg and thus the possibility of pregnancy . , the gynecologist explained. “First, the cycle becomes more irregular: sometimes ovulation does not occur, sometimes many eggs are developed quickly – as a result, sometimes a few, sometimes many hormones have an impact on health and can worsen the mood.
But it’s not just hormonal changes that can affect mood during perimenopause, but also changing living conditions, Banger explains. “The perimenopause part of life is often characterized by changes: whether children are coming out, taking care of relationships or the desire to renew yourself.” So symptoms can be caused by hormonal changes and a new phase of life – often it’s a mixture of both.
The psychiatrist explains that cultural considerations also influence how we experience menopause: “In Western countries, menopause is often considered negative and as a health ‘problem’.” renewal. In Japan, for example, menopause is accepted as a natural transition, she explains. “Menopause is a normal physiological change out there and, interestingly, women also have fewer temporary symptoms.”
Not every woman experiences the same depressive symptoms, if at all, explains Schaudig. It depends on the individual’s physical condition, previous illnesses and environmental influences. “Women who have experienced previous depressive episodes, whether the baby blues, a depressive episode or an eating disorder in their teens or later, are also at risk.”
But even women without a history of depression are not immune to the corresponding changes, he stressed the scientists: “Some develop sudden anxiety disorders, avoid driving on the highways or through the highway, for example, and experience their first panic attack.” of hormonal changes in the Perimenopause body.
If women suffer from depressive moods or other symptoms during perimenopause, learning about hormonal patterns at this stage of life can be the first step in solving it, Schaudig said. There are also many other treatment options: In addition to hormone replacement treatments, there are also non-hormonal methods. These include, for example, antidepressants, phytoestrogens, St.
According to Banger, for some women it can be helpful to accept the transition to perimenopause – similar to other cultures – as a natural process in order to reduce any symptoms of depression. However, if symptoms are severe, antidepressants may be appropriate in addition to psychotherapeutic support, the expert explained. It is important to accurately assess how severe the symptoms are.
What helps in the end depends on the symptoms and the patient’s preferences, Schaudig explains: “Some women don’t want to take hormones, others need immediate help.” So, depending on how bad it is, I decide whether to try hormone therapy first or refer me directly to a psychiatrist.”
Both experts agree that collaboration between gynecologists and psychiatrists is essential for overall care. A combination therapy that includes psychotherapeutic discussions and drug treatment is often effective, Banger said. “It is worth discussing with the patient’s gynecologist whether hormone replacement therapy can help.”
“Unfortunately, not all doctors have this topic on their radar,” Schaudig added. “Many women first go to a psychiatrist because they don’t even know that symptoms can be related to menopause.” behind you. In retrospect, early administration of hormones may have reduced her symptoms, the doctor recalled.
The topic of perimenopause is currently “on everyone’s lips,” says Schaudig. There are many discussions and movements that raise awareness about this. An example of this is Great Britain, where women have even taken to the streets to demand better care during perimenopause. There is now a theory that employers should be more considerate of women going through menopause. “In Germany we are not there yet, but we are working on it,” Schaudig said optimistically.
Banger, on the other hand, see condition In Germany, people are a little more skeptical: “Although there is an open discussion about menopause, it is often based on treatment options and is rather reserved when it comes to a full view on the subject,” he criticized.
dpa/sk
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