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Depressive symptoms across the menopause transition: findings from a large population-based cohort study

Depressive symptoms across the menopause transition: findings from a large population-based cohort study
Depressive symptoms across the menopause transition: findings from a large population-based cohort study

OBJECTIVE: The aim of the study was to describe the trajectories of depressive symptoms in a large population-based cohort of midaged women, and to examine the associations of current and changing reproductive stage with depressive symptoms over time.

METHODS: Prospective, population-based cohort study of 13,715 women aged 45 to 50 years followed up for over 15 years (Australian Longitudinal Study on Women's Health). Nearly 6,000 women provided complete data for this study. Menopause status was determined from questionnaires about hysterectomy, oophorectomy, hormone therapy, and menstrual patterns. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression scale (CESD-10).

RESULTS: Latent class analysis indicated four distinct profiles of CESD-10 scores over 15 years: stable low (80.0%), increasing (9.0%), decreasing (8.5%), and stable high (2.5%). Those with "increasing" depressive symptoms were more likely to have had bilateral salpingo-oophorectomy or be perimenopausal at baseline compared with women in the "stable low" group. Depressive symptoms were higher in perimenopausal women, (higher CESD-10 score of 0.19, 95% CI 0.02, 0.31), after hysterectomy alone (0.53, 95% CI 0.31, 0.74), bilateral salpingo-oophorectomy with/without hysterectomy (0.85, 95% CI 0.58, 1.12), hormone therapy users (0.19, 95% CI 0.01, 0.36), and after starting or stopping hormone therapy compared with postmenopausal women (adjusted for sociodemographic factors, vasomotor symptoms, health behaviors, and history of depression diagnosis or treatment).

CONCLUSIONS: Depressive symptoms follow distinct trajectories across the menopause transition. Most women have stable symptoms, but around 9% have increasing symptoms and a similar proportion (8.5%) decreasing symptoms. Increasing depressive symptoms were independent of vasomotor symptoms but were associated with oophorectomy and stopping or starting hormone therapy. A large number of women were excluded due to missing data, and thus the results should be interpreted with caution.

Australia, Depression/psychology, Estrogen Replacement Therapy/psychology, Female, Hot Flashes/psychology, Humans, Hysterectomy/psychology, Longitudinal Studies, Menopause/psychology, Middle Aged, Ovariectomy/methods, Prospective Studies
1072-3714
1287-1293
Hickey, Martha
f285f8bb-bf86-4124-8f13-59154e848adc
Schoenaker, Danielle A J M
84b96b87-4070-45a5-9777-5a1e4e45e818
Joffe, Hadine
08c74235-a452-487d-bd3d-d3a244e9f607
Mishra, Gita D
02143b82-e536-4915-9b30-3c86cbe1a1fe
Hickey, Martha
f285f8bb-bf86-4124-8f13-59154e848adc
Schoenaker, Danielle A J M
84b96b87-4070-45a5-9777-5a1e4e45e818
Joffe, Hadine
08c74235-a452-487d-bd3d-d3a244e9f607
Mishra, Gita D
02143b82-e536-4915-9b30-3c86cbe1a1fe

Hickey, Martha, Schoenaker, Danielle A J M, Joffe, Hadine and Mishra, Gita D (2016) Depressive symptoms across the menopause transition: findings from a large population-based cohort study. Menopause, 23 (12), 1287-1293. (doi:10.1097/GME.0000000000000712).

Record type: Article

Abstract

OBJECTIVE: The aim of the study was to describe the trajectories of depressive symptoms in a large population-based cohort of midaged women, and to examine the associations of current and changing reproductive stage with depressive symptoms over time.

METHODS: Prospective, population-based cohort study of 13,715 women aged 45 to 50 years followed up for over 15 years (Australian Longitudinal Study on Women's Health). Nearly 6,000 women provided complete data for this study. Menopause status was determined from questionnaires about hysterectomy, oophorectomy, hormone therapy, and menstrual patterns. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression scale (CESD-10).

RESULTS: Latent class analysis indicated four distinct profiles of CESD-10 scores over 15 years: stable low (80.0%), increasing (9.0%), decreasing (8.5%), and stable high (2.5%). Those with "increasing" depressive symptoms were more likely to have had bilateral salpingo-oophorectomy or be perimenopausal at baseline compared with women in the "stable low" group. Depressive symptoms were higher in perimenopausal women, (higher CESD-10 score of 0.19, 95% CI 0.02, 0.31), after hysterectomy alone (0.53, 95% CI 0.31, 0.74), bilateral salpingo-oophorectomy with/without hysterectomy (0.85, 95% CI 0.58, 1.12), hormone therapy users (0.19, 95% CI 0.01, 0.36), and after starting or stopping hormone therapy compared with postmenopausal women (adjusted for sociodemographic factors, vasomotor symptoms, health behaviors, and history of depression diagnosis or treatment).

CONCLUSIONS: Depressive symptoms follow distinct trajectories across the menopause transition. Most women have stable symptoms, but around 9% have increasing symptoms and a similar proportion (8.5%) decreasing symptoms. Increasing depressive symptoms were independent of vasomotor symptoms but were associated with oophorectomy and stopping or starting hormone therapy. A large number of women were excluded due to missing data, and thus the results should be interpreted with caution.

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More information

Published date: December 2016
Keywords: Australia, Depression/psychology, Estrogen Replacement Therapy/psychology, Female, Hot Flashes/psychology, Humans, Hysterectomy/psychology, Longitudinal Studies, Menopause/psychology, Middle Aged, Ovariectomy/methods, Prospective Studies

Identifiers

Local EPrints ID: 441199
URI: http://eprints.soton.ac.uk/id/eprint/441199
ISSN: 1072-3714
PURE UUID: 670e0c49-cc1f-4c0d-ae1c-e21e4a430fec
ORCID for Danielle A J M Schoenaker: ORCID iD orcid.org/0000-0002-7652-990X

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Date deposited: 04 Jun 2020 16:31
Last modified: 10 Jan 2022 03:21

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Contributors

Author: Martha Hickey
Author: Hadine Joffe
Author: Gita D Mishra

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