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Since mild emotional symptoms happen in many women during the perimenopausal years, it is important to found whether the symptoms are of adequate harshness and period to constitute major depression, generalized anxiety disorder, or panic disorder. Worsening symptoms of premenstrual dysphoric anarchy may be misdiagnosed as bipolar mood disorder. Asking the patient to keep a daily diary recording her symptoms and their sternness may help with diagnostic clearing up, and might have a gentle therapeutic effect as the woman is competent to consider her symptoms more independently.
The data on the utilize of hormones for the management of mood symptoms are bewildering and incompatible. Most studies vague the remedial consequence of estrogen have resolute on depressive symptoms rather than on a clinical diagnosis of major depression. A recent meta-analysis of 26 studies on the possessions of hormone replacement therapies (particularly estrogen) on mood found that estrogen, androgen, or estrogen and androgen in arrangement were effective in reducing depressive mood among nonclinical miserable perimenopause and menopausal women. Progesterone had less significant effect, and when combine with estrogens condensed the positive effects of the estrogens. The most vigorous effect was renowned with androgen, either alone or in combination with estrogens. Because different measures of hormones and altered dosages were used in different studies, it is not clear which, if any, is the most efficient hormone preparation, in what does it should be known, or how long it needs to be given to attain positive effects on mood.
It is possible that hormone replacement may have a beneficial effect on mood by lessening the vasomotor symptoms of the menopausal years, consequently getting better sleep and overall well-being. An association between depressive symptoms and hot flushes was observed in an American study of 426 premenopausal and perimenopausal women, though this contradicts an earlier study from Sweden.
More recently a huge double-blind study comparing placebo, estrogen only, and estrogen and progestin administered cyclically or frequently devastating to shows major variation between any of the groups on symptoms of nervousness, cognition, or distress.
Estrogen alone does not have an adequate antidepressant effect to treat a major clinical depression. However, current study of depressed aged women showed greater improvement in the group treated with estrogen substitute and the discriminatory serotonin reuptake inhibitor fluoxetine than in the groups treated with estrogen alone or placebo. The authors suggest that estrogen may augment the antidepressant effect of fluoxetine in depressed elderly women. At present this necessity still be considered a topic for additional research.
The produce of estrogen on memory and cognition has recently been a focus of interest. It has been recommended that postmenopausal women on estrogen replacement execute better- quality on tests of cognitive expertise than women not on estrogen replacement. Several studies suggest that estrogen has a protective effect against the development of dementia. There is also one study showing that estrogen enhances memory in women with Alzheimer’s disease, although recent results have not supported this.
In summary, there is currently diminutive research to support the use of hormones in treating the mood symptoms of menopause, except for the secondary benefits that may occur as a result of enhancement in vasomotor symptoms and probably related improvement in sleep. The effects of estrogen on cognition in menopausal women desire additional study.
Major psychiatric disorders such as depression or panic disorder must be treated with the appropriate psychotropic medication. Many mood disorders connected to reproductive life events in women respond well to treatment with discriminatory serotonin reuptake inhibitors. It has been recommended that antidepressants may also lessen hot flushes, and a recent study has revealed that the discriminating serotonin and nor adrenaline reuptake inhibitor venlafaxine drastically condensed hot flushes in women with a history of breast cancer or panic of embryonic breast cancer.
Many women will trait psychological symptoms to menopause. Clinicians must be conscious that the woman’s distress is real, and take a careful history that includes life stressors, history of psychiatric illness, and family history of psychiatric illness. It is not helpful to order a follicle-stimulating hormone level then exultantly announce to the woman that she is not in menopause, since her symptoms are more likely to occur in the years preceding menopause anyway.
The significance of accommodating approach and careful explanation of the brain’s role in menopause cannot be overemphasized and will facilitate compliance with antidepressant medication if it is required.
Citation: Ava H (2020) Treatment of emotional aspects of the menopause 10.S1.314. Doi: 10.35248/2157-2795.10.2020.S1.314
Received: 08-Oct-2020 Accepted: 20-Oct-2020 Published: 04-Nov-2020 , DOI: 10.35248/2157-2795.2020.10.S1.314
Copyright: © 2020 Ava H. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.