A new study published in the journal Menopause reveals that nearly one in three women diagnosed with premature ovarian insufficiency (POI), experiencing menopause before age 40, suffer from depressive symptoms—a figure higher than the general population. Researchers collected data from nearly 350 women with POI to investigate variables associated with depressive symptoms, including age at diagnosis, severity of symptoms, fertility-related grief, hormone therapy use, emotional support, and genetic causes.
The study identified psychosocial factors such as lack of emotional support, grief over infertility, and severity of menopausal symptoms as key drivers of depression in women with POI, rather than hormone levels or therapy alone. Women who were younger at the time of their POI diagnosis were more likely to suffer from depression. Fertility-related grief emerged as a contributor, with the unexpected loss of fertility being the most important factor.
"Women who lacked emotional support were more likely to suffer from depression, reinforcing the understanding that a lack of emotional support increases the risk for depression," the researchers noted. Although severe menopausal symptoms were associated with depression, hot flashes and night sweats were not found to be directly related to mood disorders.
The research revealed that hormone therapy, whether estrogen with or without progestogen, did not reduce the risk of depression. No difference was found in depressive symptoms between women using estrogen plus progestogen therapy and those not using hormone therapy. A genetic cause of POI was associated with fewer depressive symptoms.
Dr. Monica Christmas, associate medical director for The Menopause Society, emphasized the importance of these findings. "The high prevalence of depressive symptoms in those with primary ovarian insufficiency highlights the importance of routine screening in this vulnerable population," she said, according to Science Daily. "Although hormone therapy is recognized as the standard of care for those with primary ovarian insufficiency for management of some menopause-related symptoms and preventive care, it is not first-line treatment for mood disorders."
Premature menopause, medically known as POI, occurs when ovarian function stops before the age of 40 and has physical, psychological, and social consequences. Women affected by premature menopause experience the effects of estrogen deficiency, including symptoms like hot flashes and vaginal dryness, which can deeply affect mental health. Additional burdens resulting from estrogen deficiency include reduced bone mineral density and an increased risk of cardiovascular disease.
For some women, infertility due to POI means a loss of sense of control, changes in life roles, impairment of future goals, and social stigma. A recent meta-analysis found an odds ratio of 3.3 for depression and 4.9 for anxiety among women with POI compared to women without the condition. These compounded challenges contribute to the elevated risk of depression and anxiety in this population.
"Addressing behavioral-health concerns with evidence-based interventions should be part of any comprehensive POI care plan," Dr. Christmas stated, according to Science Daily. The findings stress the need for early, holistic care that incorporates psychological support and emphasize the role of psychosocial factors in depression among women with POI.
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