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That Time of Life

I had the pleasure of chatting to Dr Leonhardt recently. In this video Diane Danzebrink talks with GP and Menopause Specialist Dr Mandy Leonhardt about hormones, lifestyle, stress and the part they can all play during peri menopause and menopause. They also discuss some of the things that we can do to help ourselves. Even the word 'menopause' often causes confusion so watch, learn and get the support you need.

Changes to women’s moods and emotions during the perimenopause and menopause are extremely common; it is often the main reason menopausal women first go to see their GP. Is low mood during the perimenopause and menopause the same as depression? Can taking antidepressants help this type of low mood and/or treat other menopausal symptoms as well?

Feeling down, sad, and upset can be very common symptoms of the menopause and perimenopause. Other psychological symptoms include a drop in self­-esteem, less motivation or interest in things, anxiety and panic attacks, irritability and mood swings. It is easy to see why these feelings could be mistaken for depression, therefore, understandable why a doctor might prescribe antidepressants. In the same way that women experience premenstrual syndrome or postnatal depression, significant shifts in your hormone levels, particularly estrogen, can cause marked changes to how you feel. Some studies have shown it is the reduction in estrogen that leads to a lowering of mood, other studies have shown it is the fluctuations in hormone levels that cause the problem. Estrogen helps regulate several hormones, which may have mood­ boosting properties e.g. serotonin, norepinephrine and dopamine. Estrogen also helps to support the sharpness of your thinking skills and when levels reduce, it can lead to forgetfulness or brain fog – which can in turn lower your mood. Testosterone is another important hormone produced by the ovaries and it can also have important effects on the brain. Some pre-­existing conditions may put women at greater risk of developing mood changes during the menopause, these include a history of premenstrual syndrome or postnatal depression, high levels of stress, and poor physical health.

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 30’s or early 40’s 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 first ­line 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.




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