Using Hrt To Help With Menopausal Mood Changes
Because mood changes during the perimenopause and menopause are caused by altered hormones, the most effective treatment is to stabilise hormone levels by taking replacement estrogen . The right dose and type of estrogen can really help improve low mood and other psychological symptoms related to the menopause. Many women find that they feel calmer, their motivation and interest in things returns, along with a greater sense of energy, and they are generally much happier after a few months of being on HRT. There will usually be an improvement in other menopausal symptoms as well, such as hot flushes and night sweats, insomnia, vaginal dryness and many other symptoms.
Research has shown that if women are given HRT when they are perimenopausal, this can reduce the incidence of clinical depression developing. Many women who start HRT and have been incorrectly given antidepressants in the past, find that their depressive symptoms improve on the right dose and type of HRT, to the extent that they can reduce and often stop taking their antidepressants.
Risks Of Untreated Depression
To determine the optimal treatment for perimenopausal depression, clinicians must weigh the risks of untreated depression and the benefits of treatment. Untreated depression during the perimenopause exacerbates heart disease, diabetes, and osteoporosis. More specifically, with regard to cardiovascular disease, a higher prevalence of depressive disorders was associated with more severe atherosclerosis recurrent depressive, but not anxiety, disorders were associated with a two-fold increase in the risk of carotid atherosclerosis in middle-aged women, however, lifetime history of a single depressive episode was not associated with increased risk of plaque, suggesting that prevention of recurrent depressive episodes may prevent further progression of atherosclerosis patients with depressive symptoms have lower health benefits after coronary artery bypass surgery symptoms of depression are significantly related to increased risk of CV events in women suspected of myocardial ischemia, to death from CV disease and, based on the findings from the WHI observational study, to all-cause mortality, even after controlling for established CV disease risk factors. As Eaton reviews, major depression increases the risk of first heart attack , stroke and diabetes . In addition to depression being associated with increased bone loss and fracture, it is also associated with other menopausal symptoms of urinary incontinence and hot flashes.
Treating Menopausal Depression: What Works And What Doesnt
For a natural process, menopause can be accompanied by a bunch of seemingly unnatural changes in biology, emotional wellbeing and physical appearance. Another unwelcome challenge for women during their transition out of childbearing years is depression.
Postpartum depression may get more play in the media, but menopausal depression is a common problem for aging women, according to Sheryl Green, Ph.D., a psychologist with the Women’s Health Concerns Clinic in Hamilton, Ontario and assistant professor in the Department of Psychiatry and Behavioral Neurosciences at McMaster University. During the so-called “window of vulnerability” that occurs during menopause, women are four times more likely to develop depression, even if they have never experienced the condition before. For women who have previously grappled with depression, this risk is 13 times higher.
“The constant change and fluctuation of hormones that occur during menopause is thought to increase one’s vulnerability to mood disorders,” says Green, mainly because the hormones that are changing are also the ones in charge of maintaining mood stability. Physical symptoms such as hot flashes and trouble sleeping can also play a role in elevating depression risk.
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A New Review Study Compares 21 Antidepressants
Do antidepressants work? If so, which are most effective? These two questions have been posed again and again over the last few decades, but the answer has remained elusive.
The latest answer to the question of which antidepressants are most effective and well-tolerated comes from a 2018 paper. Published in The Lancet, the paper reports the results of the largest meta-analysis conducted to date on the acceptability and efficacy of 21 antidepressant treatments.1
What Is An Antidepressant What Is The Best Antidepressant For Menopause Depression
Beyond hormone replacement therapy to treat menopausal mood changes, anxiety and depression, there is also the option to choose non-hormonal drug therapies which have been shown to reduce some of the more frustrating symptoms of menopause.8 The most commonly talked about non-hormonal drugs used as antidepressants include gabapentin, pregabalin, and clonidine which can also help to reduce hot flashes, night sweats, and insomnia.
There are several classes of antidepressants, but the most often used are serotonin and noradrenaline reuptake inhibitors , and selective serotonin reuptake inhibitors . They are the most well-investigated group of non-hormonal antidepressants for the treatment of hot flashes. SSRI antidepressants work by increasing levels of serotonin within the brain. Serotonin is a neurotransmitter that is often referred to as the âfeel-good hormone.â SNRIs are effective at treating depression, anxiety disorders, and long-term pain.
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Using Antidepressants To Help Mood Changes During The Menopause
Research suggests that more than half of all perimenopausal women report an increase in depressive symptoms. It is therefore important that GPs have an awareness of these symptoms in women from this age group and the possible underlying causes in particular, hormonal causes. Healthcare professionals may not think of hormones as the primary cause of symptoms for women in their late 30s or early 40s for example, but it is not unusual for menopausal symptoms to start as early as this, for some women.
Menopause guidelines are clear that antidepressants should not be used as firstline treatment for the low mood associated with the perimenopause and menopause. This is because there is no evidence that they actually help psychological symptoms of the menopause.
Despite this clear recommendation, many women are inappropriately offered antidepressants when they first seek help from a healthcare professional about their menopausal symptoms.
Side Effects Of Antidepressants
Gabapentin and pregabalin can cause dizziness. Clonidine can have some side effects including hypotension, dizziness, and rebound hypertension.8 SNRIs can potentially elevate blood pressure and regular monitoring of blood pressure is needed. Because of the variable adverse effects and efficacy of SSRIs and SNRI drugs, if any one of these drugs is not effective or well-tolerated, another drug can be prescribed.8
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Drug Or Biological Treatments
Treatments for perimenopausal depression usually include antidepressants and gonadal hormones. Often, the order in which they are used depends on the clinicians particular expertise or medical specialty.
Hormone therapy alone may be appropriate for recent onset depression, without suicidality, in otherwise healthy women experiencing other perimenopausal symptoms. The hormone therapy chosen must be tailored for each patient. Recommendations by the International Menopause Society, updated in 2016,5 are a useful, comprehensive set of evidence-based practice guidelines.
Tibolone is a synthetic steroid with a mixed hormonal profile which has shown benefit in treating perimenopausal depression.6 Tibolone can cause minor intermenstrual bleeding, but does not cause increased breast density.6
Bioidentical hormones are compounds synthesised to resemble ovarian hormones. There are limited safety and dosing data on these compounds which are not recommended by the International Menopause Society.5
Combining hormone therapy and antidepressant therapy may be required for perimenopausal women with depressive symptoms that do not respond to either treatment alone. In such cases, the adverse effects of combined treatment need to be monitored carefully.
When To See A Healthcare Provider
As you enter perimenopause, it is important to let your healthcare provider know if you have suffered from depression in the past, or if you have been particularly sensitive to hormonal and reproductive changes. In addition, pay attention to mood changes you experience. Are changes mild and non-life altering or are they severe and debilitating to the point where they affect your ability to perform daily activities and enjoy your life?
Anytime depressive symptoms start causing you problems in your relationships and at work, and there are no clear solutions to what you are experiencing, you should seek help from your practitioner or mental health professional. Talking to a mental health provider or your practitioner can prevent symptoms from getting worse, especially if symptoms have been around for a long period of time.
It is important to note feeling sad from time to time does not mean you have depression. Depression not only affects your mood, but it also affects other physical aspects of your health, including your sleep, energy, appetite, motivation, and concentration. If you are experiencing these types of physical symptoms and find you are experiencing depressive mood symptoms most of the time for days and weeks at a time, you should see your healthcare provider.
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Sexual Side Effects Of Antidepressant Drugs
While women in peri- and menopause may already be suffering from sexual dysfunction symptoms due to reduced hormones, the addition of SSRIs may have some sexual side effects that include diminished sexual desire, trouble achieving and maintaining arousal, and difficulty achieving orgasm. Depression can be both a cause and a result of sexual problems.12 About 50% of people taking SSRIs report some sexual dysfunction, but some SSRIs cause less sexual dysfunction than others. Some SSRIs actually increase sexual drive and arousal in women. Ask your doctor about which medication is best for you.
SSRIs can also cause drug interactions that should not be taken lightly. Always consult a physician before taking prescription medications, changing dosages, or considering stopping. This is a delicate balancing act. Any changes in antidepressant therapy or dosing should be done only in consultation with your healthcare provider. Be sure to ask your healthcare provider about which SSRI might be best for you.
Menopause And Mood Disorders
Menopausal hormone fluctuations are problematic. Add into the mix a womanâs life stresses, interrupted sleep, weight gain, and signs of aging and you have created a perfect situation for emotional distress, which can lead to anxiety, mood swings, and depression. Menopausal women often report symptoms of depressed mood, stress, anxiety, and a decreased general happiness. Those are not feelings that should be ignored or that you should have to endure.
This phase of a womanâs life often marks significant life changes that can adversely impact their mental health too.3 Children leaving for college, helping aging/ailing parents, facing increased career demands, and now Covid-19.4 This combination of physical and environmental changes poses an increased risk of suicidality.3
Anxiety, moodiness, and depression are some of the most commonly reported issues in women aged 42-52. But there is a recognition gap between these symptoms and their relationship to menopause. This confusion may be due to a stigma surrounding menopausal transition, loss of youth, or vitality. Additionally, when the words âmoody,â âanxious,â âdepressedâ are used, it sounds like an insult. Who would even want to admit to feeling this way?
Perimenopause impacts both a womanâs mind and her body. It is critically important for women who are experiencing anxiety and depression in their late 30s and early 40s to recognize that they may be in perimenopause and that treatment is available.
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Myth: Antidepressants Are The Best Treatment For Hot Flashes
Comments: 0 | July 17th, 2018
Hot flashes are the most common symptom of menopause. Antidepressants are given out by conventional doctors for a myriad of symptoms, and hot flashes are one of them. If your doctor prescribed antidepressants for you and you are wondering if they are the right solution, please take a moment to read this post, as it can save you from making a choice that you may regret.
Why Antidepressants Arent the Answer
Conventional doctors will typically offer antidepressants such as Effexor and Brisdelle for the treatment of hot flashes in menopausal women. These are chemicals that are foreign to the human body and have many negative and dangerous side effects. You are not having hot flashes because you are deficient in antidepressants. Please consider all the negative side effects of taking this type of medication. Lets take the antidepressant Brisdelle, for instance. The FDA approved this antidepressant medication for treating hot flashes in 2013.
Take a look at the serious side effects of the antidepressant Brisdelle:
Do those side effects seem worth the risk to you?
Caution: Do not stop taking an antidepressant cold turkey.
What You Can do to Curb Those Hot Flashes
We Can Help
Are hot flashes and other menopause symptoms controlling your life? We can help. Let us guide you safely through menopause and help you to feel your best. Contact a wellness consultant today at 281-698-8698.
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Clinical Phenomenology And Epidemiology
Based on studies from menopause clinics , the most common symptom for which women seek treatment at menopause is mood change. Almost half of these women are clinically depressed and over a third experience their first episode of depression in the perimenopausal period. Two-thirds of women in London and three-quarters of women in San Diego attending a university or community menopause clinic met criteria for recurrent MDD when evaluated by a psychiatric interview. Peri- compared with pre- or postmenopausal women had a significant increase in depression rating scores. Mood and sleep disturbances were the most common symptoms in about 75% of women. Depressive episodes also are likely to recur in women with bipolar illness at menopause, and there is an increased number of suicides in women during this time period .
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Benefits And Risks Of Hormone Replacement Therapy
The main benefit of HRT is that it can help relieve most menopausal symptoms, including hot flushes, brain fog, joint pains, mood swings and vaginal dryness.
It can also help prevent thinning of the bones, which can lead to fractures . Osteoporosis is more common after the menopause.
Some types of HRT can slightly increase the risk of breast cancer and blood clots in some women. You need to discuss whether you have any risk factors with a doctor or nurse.
Evidence says that the risks of HRT are small and usually outweighed by the benefits.
Your GP can give you more information about the risks and benefits of HRT to help you decide whether or not you want to take it.
Other Potential Causes Of Depression During Menopause
While hormonal changes may directly cause depression, the symptoms those changes create can also make women more vulnerable to experiencing significant mood disturbanceseither for the first time or by aggravating an existing mood disorder. Indeed, if you were to simulate the symptoms of menopause without the hormonal component in an otherwise healthy person, you would be likely to observe a downward turn in mood. If those symptoms continued for years, or increased in severity, theres no question that the individual might fall into a lingering state of depression.
In many ways, menopause is the perfect storm for mental health disturbances. Mood swings are common and can cause significant emotional and social disruptions. Low sex drive and painful sex can be heartbreaking and frustrating and have a deep impact on your most important relationships. Night sweats prevent you from getting enough sleep, can undoubtedly fuel depression. On top of all of this, the end of fertility can bring up feelings of loss and even fundamentally redefine your understanding of yourself. It only makes sense that many women begin to experience depressive symptoms during this time. And the risk is even greater for those with a pre-existing mental health disorder women with a history of depression are thirteen times more likely to experience symptoms or relapse during menopause.
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Dont Overlook The Specialist
Your gynecologist is the very best person to speak to about menopausal symptoms, so why do so many women just grin and bear it? There are ways to reduce or eliminate certain symptoms and return to a more normal life.
Capital Womens Care can help you get beyond this period of your life with as few hiccups as possible and without major disruptions.
Myths And Facts About Anti
Anti-Depressants Does it really work well or just a myth? Shutterstock Images
There are certain myths associated with the consumption of anti-depressants that are hugely infamous. Some people believe these baseless facts and avoid treatment altogether making it worse. Lets see some of those fears and analyze the fact.
Myth: Antidepressants will only make you forget your worries and wont help to solve them.
Fact: Antidepressants will neither make you forget things nor will solve your problems. When you are depressed, you perceive your problems in a much bigger way than they actually are.
Antidepressants enhance your ability to think clearly and approach your problems with clarity. It will remove the cloud that is blocking your clear view and help you see things as they are.
This, in turn, helps you to deal with the problems in a much efficient way.
Myth: Antidepressants rob your ability to feel and put you in an emotionless state
Fact: Antidepressants are a way to positively stimulate your mind to resume proper functioning and make you feel yourself again.
There are rare cases of people feeling emotionless but that might be due to high dosage than required or consuming a specific antidepressant.
This can be controlled by reducing the dosage or trying a different one with proper consulting. In most cases, if taken the right quantity, it wont alter your personality or freeze your emotions.
Myth: Antidepressants make you gain weight
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Symptoms Women Experience During Peri Menopause And Menopause May Include:
- fatigue and lack of energy
- slowed cognitive function
- a lack of interest in once-enjoyable activities
- feelings of worthlessness, hopelessness, or helplessness
- mood swings
- crying for no reason or tearfulness
- heightened anxiety
- profound despair
Are you suffering of one or more of these symptoms?
Want to relieve your depression symptoms using safe, natural antidepressants? Want an herbal alternative that can improve your depression symptoms without antidepressant side effects?You are not the only one!
The use of complementary therapies is gaining popularity, as more people are starting to look for more natural treatments to manage their health.This is especially true of mood disorders like depression and anxiety.
Natures medicine cupboard has plenty of herbs that can help mood disorders, anxiety and depression withoutanyunwantedsideeffects. There are herbs that will help create balance for hormone related disorders, provide energy when needed or produce calming, sedative effects.