CAN VASOMOTOR SYMPTOMS CAUSE PSYCHOLOGICAL COMPLAINTS?

Yes. The instability can lead to chronic sleep deprivation and fatigue, which may result in irritability, mood swings, indecisiveness and difficulties with concentration. This is the so-called 'domino-theory', i.e. psychological complaints are secondary manifestations of disabling symptoms.

There is good evidence to show that relief of vasomotor symptoms with oestrogen therapy has beneficial effects on the psychological status too.

WHAT OTHER FACTORS MAY CONTRIBUTE TO PSYCHOLOGICAL COMPLAINTS?

Most clinicians believe that endocrine changes, interacting with socio-cultural factors, psychological factors (such as attitudes, expectations and personality) and stressful life events play a role in the generation of psychological complaints during the climacteric.

WHAT SOCIAL FACTORS ARE IMPORTANT?

In India, the climacteric has been viewed as a time of psycho-social stress involving role changes and life events such as bereavement, divorce or the departure of children from home. There is some evidence to suggest that bereavement, divorce or marital separation produces psychological and bodily complaints but the departure of children from the home (the so called 'empty nest syndrome') is not necessarily stressful or may not depend on a woman's attitude, personality and her general social situation.

Lack of social supports, such as satisfactory relationships with spouse, family or friends or the lack of available alternative roles such as employment may lead to greater experience of symptoms.
Other factors such as social class, marital and employment status have been considered in relation to psychological symptoms. Financial and housing difficulties may also be important.

WHAT PSYCHOLOGICAL FACTORS ARE IMPORTANT?

Personality, attitude to the menopause and experiences of friends and family influence reactions to the menopause.

Women with negative attitudes to the menopause and with expectations of major difficulties are more likely to complain of psychological symptoms. Also loss of socially desirable characteristics such as youth and beauty give a negative feeling leading to more psychological complaints.

It is seen that psychological symptoms are more prevalent in climacteric women with neurotic personality traits, difficulties in coping with stress and those with low self-esteem.

DO THOSE WITH A PSYCHIATRIC HISTORY EXPERIENCE MORE PROBLEMS AT THE MENOPAUSE?

Yes! Women having suffered psychiatric problems in past are likely to present with psychological complaints.

DOES MENOPAUSE CAUSE DEPRESSION?

The symptom of 'depressed mood' is often present and when combined feeling of worthlessness, anxiety, crying, fatigue, loss of drive, aches and pains, headaches etc., it is obvious as to why the clinical picture in most menopausal women suggests clinical depression.

Depressive disease, on the other hand is usually characterized by normal, persistent depressed mood associated with feelings of hopelessness, crying, suicidal tendencies, psychomotor retardation, reduced capacity to perform everyday chores and complaints suggesting physical illness such as appetite disturbance and weight loss.

The depression in perimenopausal women is a symptom and rarely part of a true depressive disease as the problems presented are less severe and not continuous but fluctuating.

HOW CAN OESTROGEN DEFICIENCY CAUSE PSYCHOLOGICAL SYMPTOMS?

Oestrogen deficiency acts in two ways

1. In the 'domino theory', recurrent night sweats lead to chronic sleep deprivation, which results in tiredness, fatigue and irritability, etc.
2. Oestrogen deficiency may have a direct effect on the CNS. Psychological complaints may reflect a change in CNS function secondary to changes in levels of certain steroids as there is now good evidence for a 'mental tonic' effect of oestrogen.

| Vasomotor Symptoms | Main Page |