Mental aspects and fat metabolic disturbance in menopause

Andreeva E.N., Sheremetyeva E.V.

1) National Medical Research Center of Endocrinology, Ministry of Health of Russia, Moscow, Russia

2) A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia, Moscow, Russia

The menopausal period is characterized by a gradual decrease and then termination of ovarian function, and is also accompanied by various specific symptoms (vasomotor, psychoemotional, vaginal, sexual, etc.) and signs of somatic health problems: loss of bone mineral density, formation of an unfavorable cardiovascular risk profile due to the development of abdominal/visceral obesity, dyslipidemia, endothelial dysfunction, glucose intolerance, as well as impaired psychological status. Postmenopausal mental disorders can occur both as part of menopausal metabolic syndrome (for example, due to relative hyperandrogenism and/or changes in body composition) and as part of an independent nosological entity. Menopausal hormone therapy (MHT) has been recognized as optimal in affecting the symptoms and diseases associated with estrogen deficiency. MHT reduces the severity of vasomotor symptoms and depressive and anxiety disorders and decreases the risk of osteopenia/osteoporosis, some cardiovascular diseases, genitourinary syndrome, and other age-related conditions.

Keywords

menopause
diabetes mellitus
depression
mental status
obesity
menopausal hormone therapy
drospirenone
psychiatrist
cardiovascular diseases

References

  1. Гаспарян С.А., Дросова Л.Д., Карпов С.М., Хрипунова А.А. Использование менопаузальной гормональной терапии в коррекции когнитивных нарушений у женщин в климактерическом периоде. Акушерство и гинекология. 2018; 12: 157-62. [Gasparyan S.A., Drosova L.D., Karpov S.M., Khripunova A.A. Ispol’zovanie menopauzal’noi gormonal’noi terapii v korrektsii kognitivnykh narushenii u zhenshchin v klimaktericheskom periode. Akusherstvo i ginekologiya. 2018; 12: 157-62. (In Russian)]
  2. Зайдиева Я.З. и соавт. Гормональная терапия в климактерии: рекомендации для клинической практики. Гинекология. 2011;1(3): 8-12). [Zaydieva Ya.Z., et al. Hormone therapy in menopause: recommendations for clinical practice. Gynecology. 2011; 13, 3: 8-12. (In Russian)]
  3. Olchowska-Kotala A. Psychological Resources and Self-rated Health Status on Fifty-year-old Women J Menopausal Med. 2015 Dec; 21(3): 133-141.
  4. Порывкина О.Н., Адашева Т.В., Задионченко В.С. и др. Эффективность и безопасность заместительной гормональной терапии у пациенток с метаболическим синдромом в постменопаузе. Кардиоваскулярная терапия и профилактика 2009; 8: 75-80. [Poryvkina O.N., Adasheva T.V., Zadionchenko V.S., et al. Efficacy and safety of hormone replacement therapy in patients with metabolic syndrome in postmenopausal. Cardiovascular Therapy and Prevention. 2009; 8: 75-80. (In Russian )]
  5. Pucci G., Alcidi R., Tap L., Battista F., Mattace-Raso F., Schillaci G. Sex- and gender-related prevalence, cardiovascular risk and therapeutic approach in metabolic syndrome: A review of the literature. Pharmacol Res. 2017 Jun; 120: 34-42.
  6. Doubova S.V., et al. Integrative health care model for climacteric stage women: design of the intervention BMC Womens Health. 2011; 11: 6
  7. Hofmeier S.M., Runfola C.D., Sala M., Gagne D.A., Brownley K.A., Bulik C. M. Body Image, Aging, and Identity in Women Over 50: The Gender and Body Image (GABI) Study J Women Aging. Author manuscript; available in PMC 2017 Jul 1.Published in final edited form as: J Women Aging. 2017 Jan-Feb; 29(1): 3–14.
  8. Li-Yu Hu et al. Risk of Psychiatric Disorders Following Symptomatic Menopausal Transition A Nationwide Population-Based Retrospective Cohort Study Medicine (Baltimore). 2016 Feb; 95(6): e2800.
  9. Bhat A. et al. The Obstetrician–Gynecologist’s Role in Detecting, Preventing, and Treating Depression Obstet Gynecol. 2017 Jan; 129(1): 157–163.
  10. Carranza-Lira S., Pablo-Cruz E. Differences in the What’s My M3? test between pre- and postmenopausal women. Prz Menopauzalny. 2017 Sep; 16(3): 104-106.
  11. Eisenlohr-Moul T.A., Rubinow D.R., Schrubbe L., Girdler S.S. Naturally Occurring Changes in Estradiol Concentrations in the Menopause Transition Predict Morning Cortisol and Negative Mood in Perimenopausal Depression Clin Psychol Sci. 2016 Sep; 4(5): 919-935.
  12. Soares C.N., Zitek B. Reproductive hormone sensitivity and risk for depression across the female life cycle: a continuum of vulnerability? Journal of psychiatry & neuroscience. 2008; 33(4): 331.
  13. Burt V.K., Stein K. Epidemiology of depression throughout the female life cycle. The Journal of clinical psychiatry. 2001; 63: 9-15.
  14. Joffe H., Hickey M. Should Hormone Therapy Be Used to Prevent Depressive Symptoms During the Menopause Transition? JAMA Psychiatry. 2018 Feb 1; 75(2): 125-126.
  15. Boneva R.S., Lin J.M., Unger E.R. Early menopause and other gynecologic risk indicators for chronic fatigue syndrome in women. Menopause. 2015 Aug; 22(8): 826-834.
  16. Harlow S.D., Karvonen-Gutierrez C., Elliott M.R., Bondarenko I., Avis N.E., Bromberger J.T., Brooks M., Miller J.M., Reed B.D. It is not just menopause: symptom clustering in the Study of Women’s Health Across the Nation Womens Midlife Health. 2017; 3: 2.
  17. Репина М.А. Менопаузальный метаболический синдром и ожирение Обзоры по клинической фармакологии и лекарственной терапии. 2003; 2 (3): 35-43. [Repina M.A. Menopauzal’nyi metabolicheskii sindrom i ozhirenie Obzory po klinicheskoi farmakologii i lekarstvennoi terapii. 2003; 2 (3): 35-43. (in Russian)]
  18. Komulainen K., Pulkki-Råback L., Jokela M., Lyytikäinen L.P., Pitkänen N., Laitinen T., Hintsanen M., Elovainio M., Hintsa T., Jula A., Juonala M., Pahkala K., Viikari J., Lehtimäki T., Raitakari O., Keltikangas-Järvinen L. Education as a moderator of genetic risk for higher body mass index: Prospective cohort study from childhood to adulthood. Int J Obes (Lond). 2017 Jul 31. doi: 10.1038/ijo.2017.174.
  19. Chedraui P., Pérez-López F.R. Metabolic syndrome during female midlife: what are the risks? Climacteric. 2019; 1-6. doi:10.1080/13697137.2018.1561666
  20. Palmer B.F., Clegg D.J. The sexual dimorphism of obesity Mol Cell Endocrinol. 2015 Feb 15; 0: 113-119.
  21. Al-Safi Z.A. et al. Obesity and menopause. Best Pract Res Clin Obstet Gynaecol. 2015.
  22. Zhu Z., Liu X., Senthil Kumar S.P., Zhang J., Shi H. Central expression and anorectic effect of brain-derived neurotrophic factor are regulated by circulating estradiol levels. Horm. Behav. 2013; 63: 533-542.
  23. Schreiber D.R., Dautovich N.D. Depressive symptoms and weight in midlife women: the role of stress eating and menopause status. Menopause. 2017 Jul 10. doi: 10.1097/GME.0000000000000897
  24. Xiong Q., Hu X., Xu Y., Zhang X., Pan X., Xiao Y., Ma X., Bao Y., Jia W. Association of visceral fat area with the presence of depressive symptoms in Chinese postmenopausal women with normal glucose tolerance. Menopause. 2017 Jun 19. doi: 10.1097/GME.0000000000000917. [Epub ahead of print]
  25. Менделевич В.Д. Расстройства зависимого поведения (к постановке проблемы). Российский психиатрический журнал. 2003; 1: 5-9. [Mendelevich V.D. Rasstroistva zavisimogo povedeniya (k postanovke problemy). Rossiiskii psikhiatricheskii zhurnal. 2003; 1: 5-9. (in Russian)]
  26. Вахмистров А.В. Клинико-психологический анализ различных форм эмоциогенного пищевого поведения. Альманах клинической медицины. 2001; 4: 127-130. [Vakhmistrov A.V. Kliniko-psikhologicheskii analiz razlichnykh form emotsiogennogo pishchevogo povedeniya. Al’manakh klinicheskoi meditsiny. 2001; 4: 127-130. (in Russian)]
  27. Каменецкая Е.В., Ребеко Т.А. Телесный образ Я у лиц с нарушением пищевого поведения. Вестник Костромского государственного университета имени Н.А.Некрасова. 2014;4: 58–64. [Kamenetskaya E.V., Rebeko T.A. Telesnyi obraz Ya u lits s narusheniem pishchevogo povedeniya. Vestnik Kostromskogo gosudarstvennogo universiteta imeni N.A.Nekrasova. 2014; 4: 58-64. (in Russian)]
  28. Klatzkin R.R., Gaffney S., Cyrus K., Bigus E., Brownley K.A. Stress-induced eating in women with binge-eating disorder and obesity. Biol Psychol. 2016 Nov 9. pii: S0301-0511(16)30337-4.
  29. Michopoulos V. Stress-induced alterations in estradiol sensitivity increase risk for obesity in women. Physiol Behav. 2016 Nov 1; 166: 56-64.
  30. Gibson E.L. The psychobiology of comfort eating: implications for neuropharmacological interventions. Behav Pharmacol. 2012 Sep; 23 (5-6): 442-60.
  31. Klatzkin R.R., Gaffney S., Cyrus K., Bigus E., Brownley K.A. Binge eating disorder and obesity: preliminary evidence for distinct cardiovascular and psychological phenotypes. Physiol Behav. 2015 Apr 1; 142: 20-7.
  32. Albanese E. et al. Body mass index in midlife and dementia: Systematic review and meta-regression analysis of 589,649 men and women followed in longitudinal studies Alzheimers Dement (Amst). 2017; 8: 165-178.
  33. Blümel J.E., Fica J., Chedraui P., Mezones-Holguín E., Zuñiga M.C., Witis S., Vallejo M.S., Tserotas K., Sánchez H., Onatra W., Ojeda E., Mostajo D. Monterrosa A., Lima S., Martino M.,Hernández-Bueno J.A., Gómez G., Espinoza M.T., Flores D., Calle A., Bravo L.M., Benítez Z., Bencosme A., Barón G., Aedo S. Collaborative Group for Research of the Climacteric in Latin America. Sedentary lifestyle in middle-aged women is associated with severe menopausal symptoms and obesity. Menopause. 2016 May; 23(5): 488-93.
  34. Blümel J.E., et al Obesity and its relation to depressive symptoms and sedentary lifestyle in middle-aged women. Maturitas. 2015 Jan; 80(1): 100-5.
  35. Ma Y. et al. Relations of depressive symptoms and antidepressant use to body mass index and selected biomarkers for diabetes and cardiovascular disease. Am J Public Health. 2013 Aug; 103(8): e34-43.
  36. Heidelberg D.A. et al. Do diabetes and depressed mood affect associations between obesity and quality of life in postmenopause? Results of the KORA-F3 Augsburg population study. Health Qual Life Outcomes. 2011 Nov 4 (9): 97.
  37. Hasan S.S. et al. Psychological health and menopause-specific quality of life of Malaysian women with type 2 diabetes. Asian J Psychiatr. 2016 Oct; 23: 56-63. doi: 10.1016/j.ajp.2016.07.005. Epub 2016 Jul 16.
  38. Kozakowski J., Gietka-Czernel M., Leszczyńska D., Majos A. Obesity in menopause – our negligence or an unfortunate inevitability? Prz Menopauzalny. 2017 Jun; 16(2): 61-65.
  39. Rossouw J.E., Anderson G.L., Prentice R.L., et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial. JAMA. 2002; 288: 321-333.
  40. Steinkellner A.R., Denison S.E., Eldridge S.L., et al. A decade of postmenopausal hormone therapy prescribing in the United States: long-term effects of the Women’s Health Initiative. Menopause. 2012; 19 (6): 616-621.
  41. Юренева С.В., Ильина Л.М. Ведение женщины в постменопаузе: на что опираться врачу в клинической практике? Медицинский совет. 2014; 9: 34-39.[Yureneva S.V., Il'ina L.M. Vedenie zhenshhiny' v postmenopauze: na chto opirat'sya vrachu v klinicheskoj praktike? Medicinskij sovet. 2014; 9: 34-39.. (in Russian)]
  42. Киселев Е.Н., Карелин М.И., Арзуманов А.А. Оценка качества жизни в онкоурологии. Качественная клиническая практика. 2003; 2: 28-32. [Kiselev E.N., Karelin M.I., Arzumanov A.A. Otsenka kachestva zhizni v onkourologii. Kachestvennaya klinicheskaya praktika. 2003; 2: 28-32. (in Russian)]
  43. Singh B.V., Mehta J.L. Interactions between the Renin-Angiotensin system and Dyslipidemia. Relevance in the therapy of hypertension and coronary heart disease. Arch Intern Med. 2003; 163: 1296-304.
  44. Wada Е., Ohshima S., Fujisawa E. et al. Aldosterone Inhibits Insulin-Induced Glucose Uptake by Degradation of IRS1 and IRS2 via an ROSMediated Pathway in 3T3-L1 Adipocytes. Endocrinology 2009; 150 (4): 1662-9.
  45. Caprio M., Antelmi A. et al. Antiadipogenic effects of the mineralocorticoid receptor antagonist drospirenone: potential implications for the treatment of metabolic syndrome. Endocrinology. 2011 Jan; 152(1): 113-25. doi: 10.1210/en.2010-0674. Epub 2010 Nov 17.
  46. Толстов С.Н., Салов И.А., Ребров А.П. Выраженность абдоминального ожирения и нарушений углеводного обмена у женщин в ранней постменопаузе и возможности коррекции выявленных нарушений. Фарматека. 2017; 3: 54-9. [Tolstov S.N., Salov I.A., Rebrov A.P. Vyrazhennost’ abdominal’nogo ozhireniya i narushenii uglevodnogo obmena u zhenshchin v rannei postmenopauze i vozmozhnosti korrektsii vyyavlennykh narushenii. Farmateka. 2017; 3: 54-9. (in Russian)]
  47. Paoletti A., Cagnacci A., Di Carlo C., Margherita Orrù M., Neri M., D’Alterio M., Melis G. Clinical effect of hormonal replacement therapy with estradiol associated with noretisterone or drospirenone. A prospective randomized placebo controlled study Gynecol Endocrinol. 2015; 31(5): 384-387.
  48. Wiener CD et al. Serum levels of nerve growth factor (NGF) in patients with major depression disorder and suicide risk. J Affect Disord. 2015 Sep 15; 184: 245-8.
  49. Dinger J.C. et al. European active surveillance study of women taking HRT (EURAS-HRT): study protocol [NCT00214903]. BMC Womens Health 2006; 6: 1.

Received 03.09.2019

Accepted 16.09.2019

About the Authors

Elena N. Andreeva, MD, professor, deputy director of the center – director of the Institute of Reproductive Medicine of the National Medical Research Center for Endocrinology of the Ministry of Health of Russia. Tel.: +79161270268. E-mail: endogin@mail.ru; professor, Department of Reproductive Medicine and Surgery, Moscow State Medical and Dental University A.I. Evdokimova Ministry of Health of Russia. https://orcid.org/0000-0001-8425-0020, eLibrary SPIN: 1239-2937
117036, Russia, Moscow, Dmitry Ulianov str. 11.
127473, Russia, Moscow, Delegatskaya str. 20, bldg. 1.
Ekaterina V. Sheremetyeva, PhD, endocrinologist, obstetrician-gynecologist at the Department of the Consultative and Diagnostic Center of the National Medical Research Center of Endocrinology of the Ministry of Health of Russia. Tel.: +7 (963)9984022. E-mail: s1981k@yandex.ru. https://orcid.org/0000-0001-7177-0254, eLibrary
SPIN: 9413-5136 117036, Russia, Moscow, Dmitry Ulyanov str. 11.

For citation: Andreeva E.N., Sheremetyeva E.V. Mental aspects and fat metabolic disturbances in menopause.
Akusherstvo i Ginekologiya/ Obstetrics and gynecology. 2019; 9: 165-72 (In Russian).
https://dx.doi.org/10.18565/aig.2019.9.165-172

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