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Menopause is a time of physical, mental and emotional change for women. Most women going through menopause experience varying degrees of moodiness and emotional upset. A significant percentage of women experience elevated instances of depression and anger. Coping with these emotions can be challenging. It is important to seek the assistance of your physician and establish a good support system. Menopause is the phase of a woman's life when she stops ovulating and stops her monthly menstrual bleeding. Menopause is associated with significant hormonal changes in particular, the rapid cessation of estrogen production by the ovaries and rapid decline in estrogen available to the woman's body. These hormonal changes cause a range of symptoms in the period leading up to menopause, known as peri-menopause or the menopausal transition. At this time, menstrual cycles become irregular and hormone levels fluctuate. Symptoms of menopause often persist post-menopause (i.e. for more than one year after a woman's final menstrual cycle). Symptoms that occur peri- and post-menopause include vasomotor symptoms (e.g. hot flushes), sexual symptoms and mood changes.
Anxiety, which may be accompanied by: Rapid heartbeat; Rapid breathing; Sweating; Dizziness; Depressed or unstable mood Phobias Low self-esteem Irritability Tearfulness Lack of motivation or energy Poor concentration Poor sleep Reduced confidence Forgetfulness; and Panic attacks.
Treatment
Hormone replacement therapy
Oestrogen
Oestrogen is the primary hormone produced by a woman's ovaries. It is implicated in numerous reproductive functions, including regulating menstruation, female sexual response (e.g. lubrication) and female sexual development. Oestrogen shows promise in relieving minor mood disorders and appears to exert an effect over and above the indirect effect of reducing hot flushes. However, further research is needed and oestrogen has not been demonstrated to be effective in treating menopausal women with major depression. There is some evidence that oestrogen can enhance the effects of antidepressants (selective serotonin reuptake inhibitors) in the treatment of depression. Oestrogen appears to be more effective in the perimenopausal period than post-menopause.
Progesterone
Progesterone is a hormone produced by the ovaries which plays an important role in regulating menstruation, pregnancy and breastfeeding. Progesterone alone appears to have a negative effect on mood in menopausal women. When progesterone is added to oestrogen for hormone replacement therapy (which is standard for all women who have not undergone hysterectomy), it reduces the moodenhancing effects of oestrogen.
Androgens
Androgens, including testosterone, are hormones produced by both males and females. Two different hormones from the androgen group, testosterone (produced by the ovaries and the adrenal gland) and dehydroepiandrosterone (produced naturally by the adrenal gland) have both been demonstrated effective in small trials for improving depressed mood in menopausal women. Testosterone has also been shown to improve menopausal anxiety.
Tibolone
Tibolone is a synthetic hormone with oestrogenic, progesterogenic and androgenic properties, meaning that it fulfils similar functions in the human body to hormones from the oestrogen, progesterone and androgen groups. Initial evidence suggests that tibolone improves mood in post-menopausal women. Further research is needed to confirm the results of early trials.
Isoflavones
Isoflavones are a type of natural oestrogen found in plants. A recent review of evidence found that red clover isoflavones significantly improved depression and mood compared to women who did not receive the treatment (placebo). These results have been confirmed in a further randomised controlled trial which showed a 76% reduction in depression and anxiety symptoms in a group of post-menopausal women receiving 80mg red clover twice daily, compared to a 21% improvement in placebo. However, researchers were unsure whether the improvement in mood was a direct result of the supplement or an indirect result due an 80% improvement in hot flushes.
Another isoflavone, soy protein, has not demonstrated any significant improvement of irritability, depression or anxiousness.
CONCLUSION
In puberty, hormones stimulate other organs to produce hormones and therefore, cause other organs in the body to start functioning. In the female the hypothalamus sends a message to the pituitary gland which causes the FSH, and LH to cause the ovaries to start producing estrogen and progesterone. It is these hormones that cause the menstrual cycle to commence. It is also the regression of these hormones that will cause the menstrual cycle to terminate at a period in life called menopause. Menopause can be a frightening and traumatizing when the female is not made aware of some of the
signs along the way. Much of this fear is credited to the lack of knowledge of hormonal change in the body. This insufficient knowledge may stem back as far as puberty or menstruation and the function of the hormones. This lack of knowledge can lead to mixed feelings and relate to more complex problems. There are many physician specialists that can help during various periods in life to arrest many of the anxieties associated with menopause.
BIBLIOGRAPHY
1) www.webmd.com/menopause/guide/emotional-roller-coaster 2) www.virtualmedicalcentre.com 3) ww.netplaces.com/menopause/perimenopause. 4) womenshealth.gov/menopause/menopause-mental-health 5) menopause.about.com 6) www.healthcommunities.com