Early Menopause Blues: Not Just About Hormones
Among women with premature ovarian insufficiency, 29.9% experienced depressive symptoms, with younger age at diagnosis, severe menopausal symptoms, and lack of emotional support being key risk factors. Oestradiol levels and the use of hormone therapy were not significantly associated with the risk for depression, underscoring the role of psychosocial factors.
METHODOLOGY:
Researchers in the Netherlands conducted an exploratory cross-sectional study of 345 women with premature ovarian insufficiency (median age at diagnosis, 32 years) to identify factors associated with the development of depression in this population.
The diagnostic criteria for premature ovarian insufficiency included oligo/amenorrhoea for at least 4 months and an elevated follicle-stimulating hormone level (> 25 IU/L) on two occasions at least 4 weeks apart.
Validated questionnaires were used to measure the severity of depressive symptoms, frequency and severity of menopausal symptoms, impact of infertility on various aspects of life, and level of emotional support.
Clinical evaluations included recording vital signs and BMI; running a blood panel for lipids and thyroid function; and measuring luteinising hormone, follicle‐stimulating hormone, oestradiol, and progesterone levels.
TAKEAWAY:
Among the 345 patients, 29.9% reported depressive symptoms and 70.1% did not.
Although 42.3% of women were using oestrogen plus progestogen therapy at baseline, no significant difference in depressive symptoms was observed between those receiving and not receiving it (P = .89); oestradiol levels and the receipt of hormone therapy were not associated with depressive symptoms in this study.
Severe menopausal symptoms (odds ratio [OR], 1.13; P < .001), lower emotional support (OR, 0.86; P < .001), and younger age at diagnosis (OR, 0.95; P = .01) were each associated with higher odds of depressive symptoms, whereas genetic aetiology was associated with lower odds (OR, 0.10; P = .04).
Among women experiencing fertility-related grief, a lower quality of life related to fertility issues was also associated with depressive symptoms.
IN PRACTICE:
"Our findings underline the need for comprehensive assessment and management of menopausal symptoms, including psychosocial and sexual well-being, in women with POI [premature ovarian insufficiency]. Addressing the psychological impact of POI, including the loss of fertility, is probably crucial in preventing or mitigating depressive symptoms," the authors wrote.
SOURCE:
This study was led by Charissa van Zwol-Janssens, MD, Division of Reproductive Endocrinology and Infertility, Erasmus MC, Rotterdam, the Netherlands. It was published online on July 15, 2025, in Menopause.
LIMITATIONS:
The observational design of the study prevented causal inferences between the identified risk factors and depression. The evaluation of symptoms at only one timepoint precluded examining trends over time or identifying at ‐ risk individuals. Moreover, enrolling participants from a single centre may have affected the generalisability of the results.
DISCLOSURES:
This study did not receive any funding. Some authors reported receiving research grants and fees for consultancy or presentations from various organisations, including pharmaceutical and healthcare companies.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
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