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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 include 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).
Funding
Funding from Newson Health Education and Research Ltd has enabled this module to be freely accessible. RCPsych retained full editorial control, and the content was developed and managed in line with our standard processes.
Availability
This module is temporarily unavailable while it is being updated in line with our Module Updates programme. Please come back soon or bookmark to complete at a later date.
