The perimenopause and menopause transitions represent a window of vulnerability for the development of mood disturbance in women. This can be explained by the marked variability in hormonal milieu that can at this time including a greater degree of oestrogen variability, low oestrogen levels, less frequent production of progesterone and a gradual loss of testosterone. The effect of these hormonal changes is likely to cause marked aberrations in intracranial neurotransmitters.
It can be difficult to distinguish between symptoms caused by a primary mood disorder compared to those caused by an underlying hormonal change, however the underlying treatment of both differ. Clinicians should enquire about oestrogen and testosterone deficiency symptoms and consider using screening questionnaires such as the MENO-D and Green Climacteric Scale. The National Institute for Clinical Excellence (NICE) guideline NG23 states: ‘Consider HRT to alleviate low mood that arises as a result of the menopause.’ (NICE, 2015) .
In this module, we will look at perimenopause and menopause in the context of mental health, the hormonal and neurotransmitter changes that occur, perimenopausal mood disorders and prescribing hormone replacement therapy (HRT).
We are pleased to offer this module free for those without a paid subscription. If you are a member of the Royal College of Psychiatrists, you can log in straight away using the same username and password with which you access the members' area of the College website. Otherwise, all you need to do is register with the College.
