Association of past and recent major depression and menstrual characteristics in midlife: Study of Women's Health Across the Nation.
Bromberger Joyce T,Schott Laura L,Matthews Karen A,Kravitz Howard M,Randolph John F,Harlow Sioban,Crawford Sybil,Green Robin,Joffe Hadine
Menopause (New York, N.Y.)
OBJECTIVE:The aim of this study was to examine the association of a history of major depression (MD) with menstrual problems in a multiethnic sample of midlife women. METHODS:Participants were 934 women enrolled in the Study of Women's Health Across the Nation, a multisite study of menopause and aging. The outcomes were menstrual bleeding problems and premenstrual symptoms in the year before study entry. The Structured Clinical Interview for the Diagnosis of DSM-IV Axis I Disorders was conducted to determine recent and past psychiatric diagnoses. Covariates included sociodemographic, behavioral, and gynecologic factors. RESULTS:One third of the participants reported heavy bleeding, 20% reported other abnormal bleeding, and 18% reported premenstrual symptoms. One third had past and 11% had recent MD. Past MD was associated with an increased likelihood of heavy bleeding (odds ratio, 1.89; 95% CI, 1.25-2.85), adjusting for recent MD, menopause status, and other covariates. Past MD was not associated with other abnormal bleeding or premenstrual symptoms in the final analysis that adjusted for recent MD. CONCLUSIONS:Midlife women with a history of MD are more likely to report heavy bleeding.
PSYCHOLOGICAL FACTORS IN 155 PATIENTS WITH FUNCTIONAL UTERINE BLEEDING.
DUTTON W A
Canadian Medical Association journal
One hundred and fifty-five women with functional uterine bleeding were studied to evaluate the importance of concomitant psychological disorders. Psychological illnesses were diagnosed in 128 patients (82.6%), most of which arose from problems directly related to sexual or reproductive functions. The remaining 27 patients (17.4%) were different in that they were psychologically stable and all but two were at puberty or approaching the menopause.Histological studies of endometrial samples from 135 of these patients indicated little evidence of abnormal sex hormone activity; 77 (57%) showed normal secretory phase endometrium and 32 (23.7%), proliferative phase endometrium. The remaining 26 (19.2%) showed evidence of some endocrine dysfunction, 15 such specimens being obtained from psychologically stable patients.It is probable that psychological disturbances are the principal cause of functional uterine bleeding during the prime reproductive years. The psychological component of the illness is the most important and determines the ultimate prognosis.
Mood and anxiety disorders in patients with abnormal uterine bleeding.
Kayhan Fatih,Alptekin Hüsnü,Kayhan Ayşegül
European journal of obstetrics, gynecology, and reproductive biology
OBJECTIVE:We aimed to investigate the prevalence of mood and anxiety disorders in patients with abnormal uterine bleeding (AUB) and the relationship between mood and anxiety disorders and AUB. METHOD:96 consecutive patients with not yet classified AUB based on the PALM-COEIN classification and 94 volunteers were included in the study. Mood and anxiety disorders were ascertained by means of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition/Clinical Version. RESULTS:Out of 96 patients, 55 (57.3%) met the criteria for at least one diagnosis of mood and anxiety disorder. The most common psychiatric disorders in patients with AUB were major depression (n=15, 15.6%), generalized anxiety disorder (n=18, 18.8%) and obsessive compulsive disorder (n=22, 22.9%), respectively. Compared with the control group, the prevalence of any psychiatric disorder (x(2)=43.52, p=0.000), any mood disorder (x(2)=10:37, p=0.001) and any anxiety disorder (Fisher's exact test, p=0.000) was higher in patients with AUB. The presence of any mood and anxiety disorder was an independent risk factor for AUB. CONCLUSION:Mood and anxiety disorders, particularly major depression, generalized anxiety disorder and obsessive-compulsive disorder were frequently observed in patients with AUB.
Anxiety and depression in adolescents with polycystic ovary syndrome and Mayer-Rokitansky-Küster-Hauser syndrome.
Laggari Varvara,Diareme Stavroula,Christogiorgos Stylianos,Deligeoroglou Efthimios,Christopoulos Panagiotis,Tsiantis John,Creatsas George
Journal of psychosomatic obstetrics and gynaecology
PURPOSE:The purpose of this study was to assess self-reported depressive and anxiety symptoms in adolescents with polycystic ovary syndrome (PCOS) and those with the rare Mayer-Rokitansky-Kuster-Hauser Syndrome (MRKHS), compared with healthy adolescents. MATERIAL AND METHODS:The participants were 49 adolescent girls, of whom 27 were patients with confirmed menstrual disorder, 22 with PCOS and 5 with MRKHS; and 22 were healthy eumenorrheic adolescents (control group) matched by age and school grade. The Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI-Gr) were used to measure depression and anxiety, respectively. RESULTS:The results showed that it was 1.08 times more likely for the PCOS group (p = 0.043) and 1.12 times more likely for the MRKHS group (p = 0.039) to have higher scores than healthy adolescents on the anxiety scale. The MRKHS group was 1.40 times more likely to have a higher number of depressive symptoms (p = 0.040) than the control group. CONCLUSIONS:These findings, although based on a small sample, suggest a relationship between PCOS and MRKHS and the presence of psychological problems, such as anxiety and depressive symptoms in adolescents. This study is among the first to examine psychological difficulties in adolescents with such a rare menstrual syndrome as MRKHS.
The late-luteal leptin level, caloric intake and eating behaviors among women with premenstrual dysphoric disorder.
Ko Chih-Hung,Yen Cheng-Fang,Long Cheng-Yu,Kuo Yu-Ting,Chen Cheng-Sheng,Yen Ju-Yu
OBJECTIVES:A marked increased in food intake in the late-luteal phase is a characteristic symptom of premenstrual dysphoric disorder (PMDD). The aim of the study was to evaluate the leptin level, caloric intake, and eating behaviors of women with PMDD across the menstrual cycle among normal-weight and overweight subjects, respectively. METHODS:A total of 62 women with PMDD and 69 controls were recruited following psychiatric interviewing and underwent prospective investigation. The leptin level, caloric intake, and three factors related to eating behavior were assessed in both the late-luteal and follicular phases. RESULTS:The women with PMDD had greater increases in caloric intake, sweet caloric intake, and uncontrolled eating in the late-luteal phase than the controls. Among the normal-weight women, the leptin level was negatively correlated with caloric intake. The normal-weight women with PMDD had a lower leptin level, a lower leptin/body fat percentage (BFP), a higher caloric intake, and higher uncontrolled eating and emotional eating in the late-luteal phase than the normal-weight controls. Their leptin level was correlated negatively with sweet caloric intake. On the other hand, the overweight women with PMDD had a higher leptin level than the normal-weight women with PMDD and no decline was observed in their leptin level in the late-luteal phase. There were no differences in the leptin level between the overweight women with PMDD and the overweight controls. They also had a higher sweet caloric intake and higher uncontrolled eating and emotional eating than the overweight controls. CONCLUSIONS:A decline in the leptin level is associated with late-luteal overeating among normal-weight women with PMDD. Hyperleptinemia and a high sweet caloric intake of overweight women with PMDD should be monitored and addressed in order to attenuate the risk of leptin resistance. The detailed roles of leptin and other psycho-neuro-endocrinology factors in the mechanism of overeating among women with PMDD should be evaluated in future study.
Menstrual-related problems and psychological distress among women in the United States.
Strine Tara W,Chapman Daniel P,Ahluwalia Indu B
Journal of women's health (2002)
OBJECTIVE:To examine the associations of menstrual-related problems with mental health and health behaviors in a U.S. population-based study. METHODS:We analyzed data obtained from women aged 18-55 years (n = 11,648) who participated in the 2002 National Health Interview Survey, an ongoing, computer-assisted personal interview of the noninstitutionalized U.S. population. RESULTS:Approximately 19% of women aged 18-55 years reported experiencing menstrual-related problems (e.g., heavy bleeding, bothersome cramping, or premenstrual syndrome [PMS]). These women were significantly more likely than those without menstrual-related problems to report frequent anxiety and depression, insomnia, excessive sleepiness, and pain over the past 12 months. Women with menstrual-related problems were also significantly more likely to report feeling sad, nervous, restless, hopeless, or worthless and that everything was an effort all or most of the time during the past 30 days. Cigarette smoking, drinking heavily, and being overweight or obese were also more frequently reported among women with menstrual-related problems than those without. CONCLUSIONS:Menstrual-related problems pose substantial implications for public health. Healthcare providers should examine mental health concerns in women reporting menstrual-related problems.
Risk factors for early postpartum depressive symptoms.
Bloch Miki,Rotenberg Nivi,Koren Dan,Klein Ehud
General hospital psychiatry
OBJECTIVE:Postpartum depressive disorders are common and symptoms may appear as early as the first 2 weeks postpartum. Data regarding hormone-related risk factors for depressive symptoms occurring in the very early postpartum period are scarce and may be of importance in identifying serious postpartum illness. We examined the association between the reported history of psychiatric symptoms of possible hormonal etiology and very early postpartum depressive symptoms. METHODS:All women (n= 1,800) in a general hospital maternity ward were assessed during the first 3 days after parturition for potential risk factors for postpartum depressive disorders by a self-reported questionnaire and for present mood symptoms (Edinburgh Postnatal Depression Scale, EPDS). The associations between potential risk factors and postpartum depressive symptoms were analysed. RESULTS:The incidence of women with an EPDS >or=10 was 6.8% (88/1,286). Significant risk factors for early postpartum depressive symptoms were a history of mental illness including past postpartum depression (PPD), premenstrual dysphoric disorder (PMDD), and mood symptoms during the third trimester. CONCLUSION:In accordance with other studies, a history of depression was found to be a risk factor for early postpartum mood symptoms. An association was also found between some risk factors of possible hormone-related etiology such as PMDD and third trimester mood symptoms and early postpartum mood symptoms. As such, early postpartum symptoms may indicate vulnerability to subsequent PPD; it may be of importance to assess these risk factors and mood immediately after parturition. A prospective study is needed to determine which of these risk factors is associated with progression to PPD and which resolves as the blues.
Predictors of first lifetime episodes of major depression in midlife women.
Bromberger J T,Kravitz H M,Matthews K,Youk A,Brown C,Feng W
BACKGROUND:Little is known about factors that predict first lifetime episodes of major depression in middle-aged women. It is not known whether health-related factors and life stress pose more or less of a risk to the onset of clinical depression than does the menopausal transition. METHOD:The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) was used to assess diagnoses of lifetime, annual and current major depression in a community-based sample of premenopausal or early perimenopausal African American and White women. Menstrual cycle characteristics, psychosocial and health-related factors, and blood samples for assay of reproductive hormones were obtained annually. Two hundred and sixty-six women without a history of major depression at baseline constituted the cohort for the current analyses. RESULTS:Over 7 years of follow-up, 42 (15.8%) women met criteria for a diagnosis of major depression. Frequent vasomotor symptoms (VMS; hot flashes and/or night sweats) (HR 2.14, p=0.03) were a significant predictor of major depression in univariate analyses. After simultaneous adjustment for multiple predictors in Cox proportional hazards analyses, frequent VMS were no longer significant; lifetime history of an anxiety disorder (HR 2.20, p=0.02) and role limitations due to physical health (HR 1.88, p=0.07) at baseline and a very stressful life event (HR 2.25, p=0.04) prior to depression onset predicted a first episode of major depression. CONCLUSIONS:Both earlier (e.g. history of anxiety disorders) and more proximal factors (e.g. life stress) may be more important than VMS in contributing to a first episode of major depression during midlife.
Effects of physical exercise on the female reproductive system.
Orio F,Muscogiuri G,Ascione A,Marciano F,Volpe A,La Sala G,Savastano S,Colao A,Palomba S
The excess in physical activity could be closely linked to considerable negative consequences on the whole body. These dysfunctions called as "female athlete triad"' by the American College of Sports Medicine (ACSM) include amenorrhea, osteoporosis and disorder eating. The female athlete triad poses serious health risks, both on the short and on the long term, to the overall well-being of affected individuals. Sustained low energy availability can impair health, causing many medical complications within skeletal, endocrine, cardiovascular, reproductive and central nervous system. On the contrary, several studies have shown, that physical activity improves cardiovascular risk factors, hormonal profile and reproductive function. These improvements include a decrease in abdominal fat, blood glucose, blood lipids and insulin resistance, as well as improvements in menstrual cyclicity, ovulation and fertility, decreases in testosterone levels and Free Androgen Index (FAI) and increases in sex hormone binding globulin (SHBG). Other studies reported that physical activity improved self-esteem, depression and anxiety. Thus, the aim of this review is to elucidate the effect of physical exercise on female reproductive system and viceversa the impact of hormonal status on physical activity and metabolism. In addition this review supports the idea that physical exercise is a helpful tool for the management of obesity, prevention of cardiovascular, metabolic diseases and female reproductive organs related diseases (e.g. breast cancer). When the excess in physical activity leads up to the female athlete triad, it is imperative to treat each component of the triad by employing both pharmacological and non pharmacological treatments.
Emotion-related impulsivity and rumination predict the perimenstrual severity and trajectory of symptoms in women with a menstrually related mood disorder.
Dawson Danyelle N,Eisenlohr-Moul Tory A,Paulson Julia L,Peters Jessica R,Rubinow David R,Girdler Susan S
Journal of clinical psychology
OBJECTIVE:Women with menstrually related mood disorders (MRMDs) demonstrate clinically significant distress during the premenstrual week that remits with the onset of menses. Relatively little is known about psychosocial mechanisms of MRMDs. Given the core affective and behavioral symptoms of MRMDs, dysfunctional responses to emotion (e.g., difficulties with awareness and regulation of emotion; rumination and impulsive or maladaptive behavior in response to emotion) may be important factors to explore as cognitive and behavioral mechanisms in MRMDs. The purpose of the present study was to examine the associations of various dysfunctional responses to emotion (as measured using the Difficulties in Emotion Regulation Scale [DERS] and brooding on the Ruminative Responses Scale [RRS]) with premenstrual symptom severity and trajectory. METHOD:A total of 54 women (mean age = 38.11; 65% Caucasian) with prospectively confirmed MRMDs completed the DERS and RRS, and provided 2-4 menstrual cycles of daily symptom reports. RESULTS:Only the emotion-related impulsivity subscale of the DERS was robustly associated with premenstrual symptom severity. Brooding rumination predicted a more rapid premenstrual increase and slower postmenstrual remission of some symptoms. CONCLUSION:Both rumination and emotion-related impulsivity may be important treatment targets in cognitive behavioral interventions aimed at reducing symptom severity and cyclicity in MRMDs.
Prevalence and related factors of irregular menstrual cycles in Korean women: the 5th Korean National Health and Nutrition Examination Survey (KNHANES-V, 2010-2012).
Jung Eun-Kyung,Kim Seok-Won,Ock Sun-Myeong,Jung Kyu-In,Song Chan-Hee
Journal of psychosomatic obstetrics and gynaecology
INTRODUCTION:There have been few population-based studies reporting medical, lifestyle and psychological factors associated with irregular menstrual cycles. This study aimed to elucidate the prevalence and related factors of irregular menstrual cycles in Korean women. METHODS:Cross-sectional data from the 5th Korean National Health and Nutrition Examination Survey were used. Eligible women were 19-40 years old, not currently taking oral contraceptives or using intrauterine devices, and not currently pregnant or breast feeding, and had no medical history of hysterectomy, thyroid diseases, cancers or renal failure. Finally, 3194 premenopausal women were recruited in this study. The prevalence and related factors of irregular cycles were obtained using a general linear model and logistic regression analyses in a complex sampling design. RESULTS:The prevalence of irregular cycles was 14.3%. Age and high-education level were associated with lower odds ratios (ORs) for irregular cycles (OR 0.91, 95% confidence interval (95% CI) 0.87-0.96, and OR 0.58, 95% CI 0.38-0.88, respectively). The ORs of body mass index, perceived stress and depressive mood were 1.05 (95% CI 1.01-1.10), 1.46 (95% CI 1.11-1.92) and 2.07 (95% CI 1.18-3.63), respectively. CONCLUSIONS:Age, perceived stress, body mass index, depressive mood and education level, rather than obstetric factors or metabolic diseases were significant factors associated with irregular menstrual cycles in Korean women. Of these factors, perceived stress is the most significant factor associated with increased irregular menstrual cycles.
Menopause and depression: is there a link?
Vivian-Taylor Josephine,Hickey Martha
AIM:Depression is common and may have significant implications for the individual, their families and work and for the health care system. The menopause transition (MT) may be an 'at risk' time for the development of depression. This review aims to explore the relationship between depression and MT and the complex interaction between the biological, psychological and social factors that inform it. METHODS:The literature on depressive disorders and MT is reviewed. RESULTS AND CONCLUSIONS:Longitudinal studies have demonstrated an association between the menopause transition (MT) and an increase in depressive symptoms. A trend towards higher rates of depressive disorders during the MT, has also been shown, although not always reaching statistical significance. Risk factors for the development of depressive symptoms and depression in the MT include the presence of vasomotor symptoms (VMS), a personal history of depression (particularly depression that is related to pregnancy or hormonal changes through the menstrual cycle), surgical menopause, adverse life events, and negative attitudes to menopause and ageing. A treatment approach to depression during the MT exploits the biological as well as the psychosocial factors that are likely to be contributing in an individual.
Association between nutritional level, menstrual-related symptoms, and mental health in female medical students.
Fukushima Keiko,Fukushima Noritoshi,Sato Hiroki,Yokota Jinko,Uchida Keiko
OBJECTIVE:Research suggests that medical students as well as women are at greater risk of depression compared to the general population and men. This suggests that female medical students are crucial targets requiring specific monitoring for mental health disorder prevention and intervention. However, little is known regarding the risk factors for poor mental health among this population. Therefore, we investigated whether menstrual symptoms and nutritional status are associated with psychological distress in Japanese female medical students. METHODS:This cross-sectional study assessed 326 female medical students who attended a school medical check-up, which included blood sampling in 2018. The levels of psychological distress were evaluated using the Japanese General Health Questionnaire (J-GHQ)-30. We defined high GHQ scores as GHQ-30 ≥7. We checked dysmenorrhea levels and assessed menstrual symptoms according to the presence of premenstrual syndrome (PMS). Dysmenorrhea was evaluated according to quartiles of the sum of the Menstrual Distress Questionnaire (MDQ). PMS was assessed using the Premenstrual Symptoms Questionnaire (PSQ). We evaluated levels of serum albumin, hemoglobin, ferritin, and lipid metabolite as nutritional factors. A multivariate logistic regression analysis was used to identify the association between menstrual-related symptoms or nutritional factors and the levels of psychological distress. RESULTS:A total of 45 female medical students (15%) experienced psychological distress. Serum albumin levels were associated with psychological distress, while lipid metabolite levels were not. The intensity of dysmenorrhea and the presence of PMS were associated with psychological distress, independent of nutritional status. CONCLUSION:Both menstrual symptoms and nutrition markers were associated with the levels of psychological distress in Japanese female medical students. School doctors and nurses can help improve the mental health of young female medical students by encouraging a healthy diet and checking for the presence of menstrual symptoms.
Maternal age and number of children are risk factors for depressive disorders in non-perinatal women of reproductive age.
Aras Neriman,Oral Elif,Aydin Nazan,Gulec Mustafa
International journal of psychiatry in clinical practice
OBJECTIVE:It remains unclear whether or not the vulnerability of depression in women of reproductive age is related with pregnancy or perinatal period. The aim of the study was to determine the prevalence of depressive disorders and related factors in a large sample of non-perinatal women of reproductive age. METHOD:This study involved 589 women of reproductive age. At baseline, sociodemographic data and premenstrual assessment forms were completed, and screening tests for the assessment of the severity of depressive symptoms were administered to all of the participants. Participants who had over scale scores of the cut-off point in the screening instruments were assessed with module A of the Structured Clinical Interview for DSM Disorders (SCID-I) to determine DSM IV Axis I disorders. RESULTS:The prevalence of depressive disorders was 32.8%. Depressive disorders had high rates in women who were married at younger ages and who had three or more children. Although the prevalence of depressive disorders was 32.8%, only 10.4% of the women had follow-up and treatment in a psychiatric outpatient clinic. CONCLUSION:Low education levels, early maternal age, and having more than three children and higher premenstrual symptom scores were risk factors for depressive disorders in non-perinatal reproductive age.
The association between mental health problems and menstrual cycle irregularity among adolescent Korean girls.
Yu Mi,Han Kyungdo,Nam Ga Eun
Journal of affective disorders
BACKGROUND:Menstrual cycle irregularity is common among adolescents and can induce mental health problems such as stress, depression, and suicidal ideation. We examined the association between mental health problems and menstrual cycle irregularity among adolescent Korean girls. METHODS:This population-based cross-sectional study was on 808 female adolescents (12-18 years of age) participating in the 2010-2012 Korean National Health and Nutrition Examination Survey. Psychological stress, depressive mood, suicidal ideations, suicide attempts, and psychological counseling were assessed through questionnaires and surveys, and hierarchical multivariable logistic regression analysis was performed. RESULTS:The risk of menstrual cycle irregularity tended to increase, as the number of mental health problems increased (P for trend=0.016). High stress levels, depressive mood, and psychological counseling were associated with increased risks of menstrual cycle irregularity (odd ratio [95% confidence interval]=1.88 [1.1-3.21], 2.01 [1.01-4.03], and 2.92 [1.16-7.34], respectively) even after adjusting for age, body mass index, alcohol consumption, smoking status, physical activity, hemoglobin level, monthly household income, weight loss attempts, age at menarche, and sleep duration. Suicidal ideation was not significantly associated with menstrual cycle irregularity. LIMITATIONS:Menstrual irregularity was evaluated based solely on subjects' self-reports, which are subject to their subjective perceptions and appraisal. Cross-sectional design and retrospective data could not draw causal relationship. CONCLUSIONS:Positive associations were observed between mental health problems and menstrual cycle irregularity among adolescent Korean girls. More attention should be paid towards mental health, to improve menstrual cycle regularity and help prevent related chronic diseases later in life.
Menstrual psychosis: a bipolar disorder with a link to the hypothalamus.
Brockington Ian F
Current psychiatry reports
The literature on menstrual psychosis is briefly reviewed in this article. There are about 80 cases with substantial evidence, and about 200 other possible cases. The clinical features are generally those of manic depressive (bipolar) disorder. The diagnosis requires the accurate dating of the onsets of episodes and of menstrual bleeding. Obtaining a baseline of several carefully dated episodes is also important in finding the best way to arrest the periodic illness. Although conventional psychotropic drugs can shorten episodes, they do not prevent recurrences. For this, unconventional treatments appear to be more effective, especially thyroid hormone and clomiphene. Patients with menstrual psychosis usually have abnormal menstruation, such as anovulatory cycles, luteal defects, or periods of amenorrhea. This, and the occurrence of episodes before the menarche, suggests that the interaction between the bipolar diathesis and menstruation is in the hypothalamus.
Depression and Its Effect on the Menstrual Cycle.
Padda Jaskamal,Khalid Khizer,Hitawala Gazala,Batra Nitya,Pokhriyal Sindhu,Mohan Ayushi,Zubair Ujala,Cooper Ayden Charlene,Jean-Charles Gutteridge
A strong association is noted between depression and early perimenopause as well as menopause. The association was found to be the greatest in women with natural menopause at the age less than 40 years. Excessive corticotropin-releasing hormone (CRH) levels in depression lead to inhibition of the hypothalamic-pituitary-gonadal (HPG) axis and increased cortisol levels which further inhibits the action of gonadotropin-releasing hormone (GnRH) neurons, gonadotrophs, and gonads. The resulting changes in luteinizing hormone (LH) amplitude, follicle-stimulating hormone (FSH) levels, and LH pulse frequency were noted in patients with depression. Besides depression, earlier surgical menopause is associated with cognitive decline. In addition, it is seen that menopausal changes predisposed females to an increased risk of depression. The association between dysmenorrhea and depression was found to be bidirectional and congruent in most studies. Patients with dysmenorrhea and coexisting depression had enhanced pain perception along with a poor response to pain relief measures. Even the treatment of underlying depression has been shown to cause menorrhagia. On the other hand, amenorrhea has also been reported as a side effect of sertraline and electroconvulsive therapy. Menstrual disorders contribute to a significant number of outpatient gynecological visits per year in the United States. Co-existing or history of depression can either be the cause of or interfere in the treatment of these disorders. Furthermore, the treatment of depression can be the etiology of various menstrual abnormalities, while menstrual disorders themselves could be the cause of depression. The increasing prevalence of depression, women's health, multiple female-specific subtypes, and the preexisting burden of menstrual disorders necessitates more detailed studies on the effects of depression on the menstrual cycle.
The etiology of some menstrual disorders: a gynecological and psychiatric issue.
Sheinfeld Helen,Gal Michael,Bunzel Michael E,Vishne Tali
Health care for women international
Some menstrual disorders with distinct gynecological character such as amenorrhea or menometrorrhagia (MMR) may have psychogenic etiology. On the other hand, in menstrual psychosis (MP), a distinctly psychiatric disorder, the etiology is not necessarily psychogenic, but rather is hormonal-biological. We present 4 cases, one each of primary and secondary amenorrhea, MMR, and MP, respectively. In the first 3 cases (2 amenorrhea and 1 MMR), we found psychogenic factors: an insult to feminine development after rape (case 1) or marriage problems (cases 2 and 3). In the case of a recurrent MP, no relevant psychological etiology was found. Furthermore, some of the patient's relatives had menstrual or peripartum psychiatric disorders. Menstrual disorders' etiology can be psychogenic or hormonal. The correct etiology is the guide for the adequate therapeutic way: psychotherapy based in psychogenic disorders and neuroleptic or antiovulatory drugs in those of biological etiology.
Hypothalamic-Pituitary-End-Organ Axes: Hormone Function in Female Patients with Major Depressive Disorder.
Zhu Yuncheng,Wu Xiaohui,Zhou Rubai,Sie Oliver,Niu Zhiang,Wang Fang,Fang Yiru
Classic hypothalamic-pituitary-end-organ feedback loops - the hypothalamic-pituitary-adrenal axis (HPAA), hypothalamic-pituitary-thyroidal axis (HPTA), and hypothalamic-pituitary-gonadal axis (HPGA) - are associated with the neuroendocrine and immune systems in major depressive disorder (MDD). Female patients with MDD present with evident neuroendocrine and immunological changes. Glucocorticoid, thyroid hormone, and reproductive steroid levels fluctuate with menstrual cycles, which might lead to glucocorticoid receptor resistance, impairment of triiodothyronine conversion, and sex hormone secretion disorders. In this review, we summarize the independent and interactive functions of these three axes in female MDD patients. The similar molecular structure of steroids implies an interrelationship between the hypothalamic-pituitary-end-organ axes and the competitive inhibitory effects at the receptor level, especially when considering the HPAA and HPGA.
Psycho-Biological Changes with Add on Yoga Nidra in Patients with Menstrual Disorders: a Randomized Clinical Trial.
Rani Khushbu,Tiwari S C,Kumar Santosh,Singh Uma,Prakash Jai,Srivastava Neena
Journal of caring sciences
INTRODUCTION:Menstrual disorders are common problems among women in the reproductive age group. Yuga interventions may decrease the physical and psychological problems related to menstrual disorders. The present study was aimed to assess the effect of Yoga Nidra on psychological problems in patients with menstrual disorders. METHODS:A total number of 100 women recruited from the department of obstetrics and gynecology and were then randomly allocated into two groups: a) intervention received yogic intervention and medication for 6 month, and b) control group received no yogic intervention and they only received prescribed medication). Psychological General Well-Being Index (PGWBI) and hormonal profile were assessed at the time of before and after six months on both groups. RESULTS:The mean score of anxiety, depression, positive well-being, general health, and vitality scores, as well as hormonal levels, in posttest were significantly different in intervention group as compared with pretest. But there was no significant difference in control group. CONCLUSION:Yoga Nidra can be a successful therapy to overcome the psychiatric morbidity associated with menstrual irregularities. Therefore, Yogic relaxation training (Yoga Nidra) could be prescribed as an adjunct to conventional drug therapy for menstrual dysfunction.
Pubertal timing, menstrual irregularity, and mental health: results of a population-based study.
Toffol Elena,Koponen Päivikki,Luoto Riitta,Partonen Timo
Archives of women's mental health
Reproductive events have a significant impact on women's lives. The aim of this study was to analyze the effects of age at menarche and current menstrual irregularity on psychological well-being and psychopathology. Data were collected in the context of the Finnish population-based Health 2000 study with self-administered questionnaires, a home interview, and a clinical health examination. The Beck Depression Inventory (BDI-21), the General Health Questionnaire-12 (GHQ-12), and the Composite International Diagnostic Interview (M-CIDI) were used to assess psychopathology. The relationships between age at menarche and current menstrual flow irregularity vs. BDI-21 and GHQ-12 scores and M-CIDI diagnoses were studied among 4,391 women aged 30 years and over. Negative, nonsignificant associations were found between age at menarche and BDI-21 and GHQ-12 scores. Young age at menarche was associated with increased risks of any recent mental disorder (OR = 0.894, p < 0.01), major depressive episode (OR = 0.900, p < 0.05), major depressive disorder (OR = 0.888; p < 0.05), and anxiety disorder (OR = 0.892; p < 0.05). Menstrual irregularity was associated with BDI-21 (p < 0.001) and GHQ-12 (p < 0.05) scores, but not with any recent psychiatric diagnosis. Age at menarche and menstrual irregularity have an influence on mental health, particularly on mood and anxiety symptoms. Reproductive features (age at menarche and menstrual irregularity) should be paid attention to during psychiatric evaluations.