Hormonal and Biological Changes In Women during Postpartum and Menopause - Research Paper Example

? Hormonal and Biological Changes In Women during Postpartum and Menopause Introduction Women experience varied fluctuations of hormones at different stages of their lives. Meaningful hormonal influences set in at twelve years when puberty begins. As women progress during puberty towards twenty years, they begin to experience premenstrual symptoms. Some girls experience severe cases of premenstrual symptoms while others only have mild symptoms. Becoming pregnant marks an entry to another distinct fluctuation of hormones coupled with increased anxiety especially fop women carrying their first child. Women learn to cope with these changes that last through out the gestation period. However, the period after giving birth comes with overwhelming hormonal changes that have the potential to send a woman into a clinical depressive mood called post partum depression. In addition, the entry into menopause brings about complex hormonal and biological changes that are the cause of menopausal depression. Understanding of the real causes and contributing factors to postpartum and menopausal depression is crucial to help women deal with the situation. Depression affects body functioning, thoughts, mood and the patient has increased anxiety, fear, low self esteem, lack of concentration, insomnia and the individual is usually out of good shape. There are multiple causes of menopausal and postpartum depression. Research reveals that hormonal imbalances have a great contribution to menopause. Women start to experience these changes in the premenopausal phase of life, which ranges from two to fifteen years before menopause. The transition comes with mood changes, anxiety, and hot flashes (Freeman, Sammel and Lin, 2010). A woman enters menopause when she ceases to menstruate for twelve consecutive months and this marks the end of her reproductive journey. On the hand, postpartum period beginning immediately after birth comes with overwhelming anxiety. It is normal for a woman to experience a level of anxiety on the arrival of a baby probably because of the new responsibility and hormonal changes that occur after birth before the body can return to the pre-pregnancy state. Postpartum blues is normal but an advanced disorder may result four weeks after birth and persist through the first few months of postpartum period. Women who experience postpartum blues are more susceptible to postpartum depression. Researchers have been carrying out neurobiological and hormonal studies to establish an explanation for post partum and menopausal causes. Article Summaries Richards, M. et al. (2006). Premenstrual symptoms and perimenopausal Ddepression. Am J Psychiatry, 2006; 163: 133-137. Research carried out sought to establish if ovarian steroids were responsible for both premenstrual and premenopausal depression. In addition, the research aimed at establishing the correlation if any between the two forms of depression. Experimental subjects were women seeking menopause depression therapy from a clinic. Out of 315 women attending the clinic, qualified for the research and the age range was 40-55. The researchers used follicle stimulating hormone test (FSH-TEST), 21-item Beck depression inventory, and a 30-days daily symptom rating to selective the most appropriate subjects. Through out the research period, the group took no medication. The other group consisted of 35 participants who were in their midlife, suffered no depression, and were on no medication. This group filled in a semi-structured questionnaire with the help of a research staff at the national institute of mental health clinic. They gave details of their menses, premenstrual depression, anxiety level, hot and night flashes, loneliness, isolation, irritability, sexual disinterest, and impaired concentration. The methodology involved analysis of the self reports from the subjects and data from the daily symptom rating of the participant with the help of a researcher from the 35 healthy and the 70 depressed women. Using the chi square analyses, the researchers established that the two conditions were independent of each other. A high number of women experiencing perimenopausal depression experienced premenstrual symptoms and menses-related symptom cyclicity. The researchers drew a conclusion that that the premenopausal depression increased cases of premenstrual symptoms. This research provided important information but had weaknesses that on improvement can provide information that is more accurate. In the first place, daily ratings used spanned for 30 days and not the recommended 60 days and this limits the reliability of data. In addition, it exaggerates the occurrence of premenstrual symptoms among women undergoing menopausal depression phase. The research does not giver exact findings on the contribution of ovarian hormones to the two types of depressions but centers on the comparison. Freeman, W. et al. (2006). Associations of hormones and menopausal status with depressed mood in women with no history of depression, Arch Gen Psychiatry. 2006; 63: 375-382. Data obtained in this research was crucial in establishing whether hormones and menopausal status were the responsible for the occurrence of depression in women who had no history of depression before the menopausal transition. The research obtained data from randomly selected subset of a population cohort. The cohort consisted of 436 women from Philadelphia County, in Pennsylvania. Random selection involved making calls to different households in Philadelphia. 231 women who proved to have had no history of depression underwent examination in the 8-year long cohort. The participants ranged from age 35 to 47, had their uterus intact, had been menstruating normally, and had at least one of the ovaries in place at the time of enrolling into the cohort. Women on contraception, alcohol or drug abuse or hormone replacement therapy, pregnant, breastfeeding, and those diagnosed with health issues likely to affect the ovaries were not eligible for the study. The research involved carrying out 10 assessments. Six of the assessments were eight-month intervals while the rest took place on a yearly basis. Assessments consisted of two domestic visits that gave the researcher time to interview each participant and obtain blood samples for the monitoring of hormones. The interviewers noted the cycle dates, general reproductive history and health status and demography. They also established whether the participants took drugs, alcohol, or any medication. Experiment variables included menopause status, hormone levels, outcome variables, and other risk factors. Menopause status fell into two groups namely the premenopausal and the transition group. Women in the transition group menstruated once in twelve months whereas the premenopausal still exhibited regular menstruation. The study was a within woman type and the outcome variables depended on The CES-D 20 self reports. The cut off score on the centre for epidemiologic studies depression was 16. Women with this value and above indicated severe depression. The study considered other risk factors such as smoking, other sources of stress, marital status, family, employment, and other contributing factors. The study used a standard conditional (fixed effects) logistic regression model in estimation of within-woman changes noting increases and decreases for the 10 assessments. The results revealed that 50% of the 231 indicated very high CES-D score while twenty six percent of these women had mild depressive disorder. Those with high CES-D scores displayed severe depression. Forty-seven percent did not show any form of depression. It was evident from the study that the menopause transition and the hormonal; changes associated with contributed greatly to the occurrence of depression. The study provides reliable information on the contribution of hormone to depression. Its longitudinal nature, design, variables under study and data analysis presents a standardized research. Sacher, J. et al. (2010) Elevated brain monoamine oxidase A binding in the early postpartum period. Arch Gen Psychiatry. 2010; 67(5): 468-474. Sacher et al (2010) carried out a research to establish the cause of the depressive episodes that occur in the postpartum period. The prevalence of the condition necessitated the study. The researchers were aware of the occurrence of blues in the postpartum period and realized that depression advanced from the blues. In addition, the study operated on the understanding that estrogen levels reduced in the postpartum period at a great rate. Changes in estrogen were inversely proportional to the level of monoamine oxidase A (MAO-A). The study took the first initiative to measure the MAO-A level in mothers during the postpartum period. The case study carried out an examination in fifteen healthy women in the postpartum phase and compare with a control of fifteen healthy women who had not been in the postpartum period for a reasonable time. The minimum time in this case was three years. Other factors considered in determining eligible participants included, non-smoking, no neuro-toxin use and a prior test for urine drugs mandatory. In addition, the participants underwent a structured clinical interview to determine if they had a history of any depression belonging to the group DSM-IV. The researchers subjected the participants to one session of C-harmine PET scanning during the first week of giving birth. Since the half-life of C-11 is 20 minutes, the mothers stood 13 half-lives and fasted prior to the scan. Magnetic reasonance (MR) proved useful in providing images of the regions of interest. The regions of interest were prefrontal cortex, anterior cingulate cortex, hippocampus, dordal putamen and other regions where MAO-A was present. The study generated values on the total MAO-A distribution volume. The analysis of the results compared the MAO-A levels between the two groups under study. This depended on the ROI imaging results. In addition, the research considered voxelwise results. It was evident from this research that MAO-A levels elevated during postpartum period because of the falling estrogen levels. In addition, the study established that the fifth day of postpartum period had the highest level of MAO-A and the mothers experienced increased mood instability. The study drew the conclusion that the increase of MAO-A degraded monoamines such as dopamine and serotonin which are responsible for good moods. The unavailability of such monoamines causes the depressive effects mothers experience after birth. Increasing availability of the MAO-A results from the fall in estrogen and the result is degradation of monoamines and mothers enter into depression. The study provided a new evidence for the cause of depression during postpartum period. Being a case study, it sheds light onto anew field of reliable source of information. Conclusion Although there have been several researches on the causes of menopausal and postpartum depression, there are still causes of concern and more varied sources of evidence. The articles described above indicate that hormones contribute greatly to the two types of depression in woman’s transitory phases. Women suffer adversely because of hormonal imbalances and research should concentrate on establishing a remedy for the effects of hormonal changes that do not have adverse effects. In addition, psychologists should work on providing a prophylaxis to these forms of depression. As a female, having knowledge on the prevention of these forms of depression will be useful. References Freeman, W. et al. (2006). Associations of hormones and menopausal status with depressed mood in women with no history of depression, Arch Gen Psychiatry. 2006; 63: 375-382. Freeman, W., Sammel, D. and Lin, H. (2010). Temporal association of hotflashes and depression in the transition to menopause. Menopause. 2009 Jul-Aug; 16(4): 728-734. Richards, M. et al. (2006). Premenstrual symptoms and perimenopausal Ddepression. Am J Psychiatry. 2006; 163: 133-137. Sacher, J. et al. (2010) Elevated brain monoamine oxidase A binding in the early postpartum period. Arch Gen Psychiatry. 2010; 67(5): 468-474. Read More