Menopause - Complications

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• Being tall and thin
• Being Caucasian
• Smoking
• Taking thyroid hormone
• Being sedentary
• Early menopause or surgical menopause (removal of ovaries)

Women at risk for osteoporosis should have a bone density test to measure their bone mass and then make a decision about treatment after consulting their doctor.

Menopause and Depression

Depression may occur as a woman transitions into menopause (perimenopause), even among women with no history of clinical depression. Hormonal changes and declines in estrogen levels are probably involved in this process. Research suggests that a depressive disorder is 2.5 times more likely to develop during perimenopause than premenopause. Women who transition to menopause at a younger age are at increased risk of a first episode of depression.

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Symptoms of clinical depression include:

• Loss of interest or pleasure in activities once enjoyed
• Persistent (longer than 2 weeks) sad mood
• Decreased energy
• Sleep problems (insomnia or oversleeping)
• Feelings of guilt, worthlessness, and hopelessness
• Difficulty concentrating

Some of these symptoms may overlap with other symptoms that typically accompany perimenopause. Women who experience these symptoms should talk to their doctor. Depression is treatable. [For more information, see In-Depth Report #8: Depression.] For many women, depression eases once they reach menopause.

Estrogen Loss and Mental Decline

Estrogen, the primary female hormone, appears to have properties that protect against the memory loss and lower mental functioning associated with normal aging. Estrogen's effects on the brain include:

• Laboratory studies suggested that estrogen may help block production of beta-amyloid, the source of the sticky plaques found in Alzheimer's brains.
• Estrogen may trigger the temporary growth of nerve pathways in the memory portion of the brain.
• Estrogen may stimulate production of the neurotransmitters acetylcholine and serotonin, which are depleted in Alzheimer's patients.
• Estrogen also appears to smooth, relax, and open blood vessels, which may help blood flow in the brain.
• Estrogen is an antioxidant. That is, it helps clean up free-oxygen radicals, the unstable particles thought to play a role in Alzheimer's.
• Studies have been mixed on the association between natural estrogen levels and mental functioning in older women.