What are the Psychosocial Effects of Menopause?
As we enter the twenty-first century, we know that many women will live more than a third of their lives during menopause. Concerns about mental health and function appear to fall into four main categories during perimenopause, menopause and post menopause. Cognitive function, mood changes, depression, and Alzheimer's disease. In some women, changes occurring in one or more of these categories can be dramatic. In others, the changes are mild or absent. Research in these areas gradually constitutes the guiding criteria for these psychological and social issues.
After menopause, studies investigating the location of oestrogen in the cognitive functions of women, especially in learning and verbal memory, have improved in memory functions when exogenous oestrogen was given to postmenopausal women in a Canadian study. One year after treatment was discontinued, the memory functions of women decreased to their previous levels. It shows that the memory improvement provided by this oestrogen continues only if women continue to take hormones.
Studies examining the link between oestrogen and memory provide an ever-increasing support for the possibility that oestrogen specifically helps maintain short-term and long-term oral memory in women.
Many menopausal women often report mood swings. Fragility, restlessness and melancholy can be part of this syndrome. Studies show that exogenous (externally given) oestrogens at physiological doses relieve certain symptoms of depression when given to postmenopausal women. But these have no real impact on a deeper mood disorder of a major depressive disorder. Oestrogen affects serotonin (happiness hormone) metabolism in many ways and causes an increase in the level of serotonin in the blood. This provides correction of mild mood changes due to menopause. However, oestrogen has no effect on women with severe depression and those diagnosed with clinical depression, which should not be forgotten.
Menopause and Depression
It has long been thought that women tend to depression. Menopause has historically been viewed as a period of deep depression, loss, and anger. Studies show that sociocultural and personal factors are more important than hormonal factors in triggering depression in menopause. The overlapping burden of career and family pressures appears to increase burden for women. In this period, the incidence of depression is higher than its occurrence before. In addition, those with a history of depression are more likely to have a middle age recurrence. For this reason, menopause should be a physiological problem as well as a psychosocial and should be evaluated considering a woman's entire life situation.
Antidepressant drugs should be primary care in the treatment of clinical depression. Oestrogen has no therapeutic effect in women with moderate to severe depression.
Menopause and Alzheimer's
Age is the strongest risk factor for Alzheimer's disease. It is rare under the age of 50. The risk increases with age and the risk rises to about 15% in people aged 65. It is about two times more common in women than in men. There are some studies showing that the use of oestrogen in postmenopausal period will be effective in reducing dementia and Alzheimer's. In general, these studies show a 29% reduction in the risk of developing dementia among oestrogen users. Four prospective studies examining oestrogen therapy in women with Alzheimer's disease have shown positive results, but the number of participants is small, the duration of treatment is short, and studies are not randomized.