Scientific Society Symposium

Transition to menopause: emotional vulnerability to falling hormones

Susana Pilnik (AR)


Women in her psychoneuroimmunoendocrinologycal universe – Organized by the Sociedad Argentina de Endocrinologia Ginecologica y Reproductiva(SAEGRE) Transition to menopause: emotional vulnerability to falling hormones Susana Pilnik MD The menopause transition constitutes a period in woman’s life that is affected by physical and psychological changes. Ovarian steroids regulate many of the processes and neuronal circuits responsible for these changes. Recent evidence from prospective studies suggests that for a subgroup of women, fluctuations of gonadal hormones were associated with the onset of affective disorders. These endocrine events during the menopause transition play a main role in mood swings, favoring women's greater vulnerability to depression. As a consequence of fluctuations of serum estradiol levels, the hypothesis of the hypothalamic-pituitary-adrenal axis (HPA) dysregulation has been widely investigated and could be involved in mood disorders. Some polymorphisms of the GABA A receptor as well as the personal history of postpartum depression or premenstrual dysphoric disorder have also been associated. Metabolic disorders frequently observed in this stage, such as insulin resistance, metabolic syndrome or diabetes, have been associated with an increased risk of mood disturbances. Other research focused on relating the impact of certain personality types with its effects on affective disorders and depression risk increase. Future investigation should allow us to identify underlying risk factors and indicators during the menopause transition in women who develop affective disorders or depression. Understanding the biological basis of this phenotype is necessary to perform an adequate intervention and even predict the response we will obtain when indicating a specific treatment.