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Review
. 2001 Mar;119(2):78-83.
doi: 10.1590/s1516-31802001000200008.

The perimenopause, depressive disorders, and hormonal variability

C N Soares  1 , L S Cohen
Affiliations
Review

The perimenopause, depressive disorders, and hormonal variability

C N Soares et al. Sao Paulo Med J. 2001 Mar.

Abstract
in English, Portuguese

Context: Several investigations have postulated that the perimenopause may represent a period of increased psychiatric vulnerability, particularly for mood disorders. This review characterizes the perimenopause, including biological changes, the influence of psychosocial factors and the most common clinical manifestations. Clinic-based studies and community-based surveys addressing the prevalence of depressive symptoms in perimenopausal women are critically reviewed. We also discuss the potential greater vulnerability to mood disturbance during the perimenopause in response to hormonal variability. A therapeutic algorithm for management of depressive symptoms in middle-aged perimenopausal women is also presented. The role of estrogen in the treatment of perimenopausal depressive symptoms is particularly discussed. In addition, we review the existing data regarding the potential efficacy of estrogen as an antidepressant agent (monotherapy, augmentation strategy or prophylaxis).

Design: Narrative review.

CONTEXTO:: Diversos trabalhos têm apontado a peri-menopausa como um período de maior vulnerabilidade para o surgimento de transtornos psiquiátricos, particularmente os quadros depressivos. Esse artigo revisa, primeiramente, o conceito de peri-menopausa, descrevendo suas características clínicas, alterações biológicas e aspectos psicossociais. Estudos sobre a prevalência de transtornos depressivos durante a peri-menopausa, abordando diferentes sub-populações (mulheres atendidas em serviços ginecológicos especializados, estudos populacionais transversais e longitudinais), são discutidos de forma crítica. Nesse artigo também abordamos as alterações hormonais presentes durante a transição menopausal, e o seu possível papel de "gatilho" no surgimento/exacerbação de quadros depressivos. Apresentamos um modelo de abordagem terapêutica para os quadros depressivos surgidos entre mulheres na faixa etária correspondente à peri-menopausa. O papel da terapêutica de reposição hormonal, nesses quadros, é discutido através da revisão dos estudos existentes sobre o uso de estrógenos como agente antidepressivo (monoterapia, terapêutica adjuvante ou profilaxia).

TIPO DE ESTUDO:: Revisão narrativa

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Conflict of interest statement

Conflict of interest: Not declared

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