PERIMENOPAUSAL SYNDROME AND

MOOD DISORDERS IN PERIMENOPAUSE:

PREVALENCE, SEVERITY,
RELATIONSHIPS AND RISK FACTORS

JOURNAL READING
ICHA LEANDRA W.
INTRODUCTION
Population of people above
60 years of age is
increasing, life expectancy MENOPAUSAL
of women is 6-8 years TRANSITION
longer than men
EARLY
Women live a longer life, yet PREMENOPA
POSTMENOPA
USE
suffer from disease and USE
disabilities related to
menopausal transition
Perimenopausal symptoms: PERIMENOPAUSE
not life threatening, negative
impact on the quality of life
and the physical and mental
health
 Premenopause: regular menstrual cycle with 12 menstruations
during the past 12 months
Menopausal transition: several menstruation,<12 menstruation
during the past 12 months
Early postmenopause: no menstruation during the last 12 months

WHO: Permanent cessation of menstruation and a decrease in the

levels of ovarian steroid hormones (estrogen and progesteron) due
to loss of ovarian follicular function
Final menstrual period: 12 consecutive months of amennorhea in
the absence of other pathological or physiological issue
Ranging between 40-60 years of age
MATERIALS AND
METHODS
1. Inclusion and Exclusion criteria
Inclusion: women who met the standards of Stages of
Reproductive Aging Workshop (STRAW): healthy body, healthy
uterus and at least one healthy ovarium
Exclusion: chronic irregular menstruation with pathological
causes, hysterectomy,abnormal anatomical structure of uterus or
ovari, psychiatric illness, hormone therapy, hyperthyroidism

2. Criteria for BMI

4 grades: BMI <18.5 (underweight), 18.5<BMI<24 (normal),
24<BMI<28 (overweight), and BMI>28 (obese)
MATERIALS AND
METHODS
3. Study participants
Total of 1200 women, 40-60 years of age, from 3 communities
in Shanghai between April-July 2014 using cluster sampling
46 participants questionnaire were incomplete, 5 with oral
medications (contraceptives, hormones, psychotropic), 27 with
gynecological diseases, and 13 for artificial menopause were
excluded
Total of 1062 participant were enrolled in analysis
4. Procedures
Self administrated questionnaires: General condition, Kupperman
index, Self-rating Depression Syndrome (SDS), Self-rating
anxiety Syndrome (SAS)
MATERIALS AND
METHODS
5. Statistical Analysis
Used the SPSS version 16.0
Descriptive statistics: summarizes characteristics of
participants the prevalence and severity of
perimenopausal syndrome and mood disorders, and the
frequency of each symptoms
Continuous data expressed as mean (SD), comparisons of
2 or more variable were performed by t-test for equal
variances or Wilcoxon rank test. ANOVA and Kruskal-
Wallis used for comparisons of 3 or more groups. The
relationship between perimenopausal syndrome and
mood disorders were assesed with x2 test
RESULTS
GENERAL CHARACTERISTICS:
The mean age of participants was 49.664.24 years,
78.72% were 45-55 years old
The mean BMI was 22.902.53 kg/m2 and 67.98% normal
91.15% were employed or retired, 86.06% had medical
insurance, 94.73% were married or cohabiting
53.11% had regular menstruation, 91.53% had a history f 1
to 2 pregnancies
Kupperman Score: 116(10.92%) had perimenopausal
syndrome, 946 (89.08%) did not
RESULTS
PREVALENCE AND SEVERITY OF PERIMENOPAUSAL
SYNDROME:
10.92% had perimenopausal syndrome, 75.86% had mild,
24.14% moderate symptoms and no severe symptoms
Frequency of perimenopausal syndrome increases with
advancing age:: 17.54% in 55-60 age groups (P<0.001)
67% participants experienced at least one perimenopausal
symptom, most common symptom was fatigue (54.24%).
Dizziness (44.63%),insomnia (40.68%), headache (38.98%),
arthralgia and myalgia (37.48%), hot flashes and night
sweats (32.02%), palpitations (31.45%), anxiety (24.11%),
depression (13.18%)
Divided as 4 categories: vasomotor (hot flashes and night sweat)
neuropsychiatric (insomnia, anxiety, depression), cardiovascular (dizziness,
headache and palpitations) and skeletal symptoms (arthralgia and myalgia)

Prevalence: 68.63% skeletal symptoms, 52.17% neuropsychiatric

symptoms, 50.19% cardiovascular symptoms and 32.03% vasomotor
symptoms
SDS:
25.99% of participants experienced depression, most women had mild or
moderate, whereas only 0.19% experienced severe depression.
Prevalence lowest in 55-60 age groups.
SAS:
12.62% experienced anxiety, mild-moderate
Age, employment status, personality characteristics, menstruation,
were risk of perimenopausal syndrome.
Disharmonious family relationship, irregular menstruation, and
severity of perimeopausal syndrome were risk factors of
depression
DISCUSSION