Role of stressful life events and menopausal stage in wellbeing and health.
Stress plays an essential role in the development, continuation and exacerbation of mood problems throughout a woman's life. It exacerbates somatic symptoms of menopause, increasing the risk of recurrence of mood disorders, as well as of a mood disorder de novo throughout the lifespan and specifically in the menopausal transition. Chronic stress affects the hypothalamic-pituitary axis, hypothalamic-pituitary-ovarian axis, the proinflammatory cytokines and cardiovascular risk. The current evidence for the potential interactions between acute stress, chronic stress, childhood stress and victimization, and individual susceptibility to the development of depression and/or anxiety in response to stressful life events, are reviewed in the context of the increasing data on the association of these and a symptomatic menopausal transition. Strategies for the optimal approach for clinicians to evaluate and treat the symptomatic perimenopausal patient with stressful life events and comorbid mood disorders are presented.
Alexander
Jeanne Leventhal
JL
Psychiatry Women's Health Program, Kaiser Permanente Northern California, Oakland, CA, USA. jeanne@afwh.org
Dennerstein
Lorraine
L
Woods
Nancy Fugate
NF
McEwen
Bruce S
BS
Halbreich
Uriel
U
Kotz
Krista
K
Richardson
Gregg
G
D005260:Female; D006304:Health Status; D006801:Humans; D008016:Life Change Events; D008593:Menopause / Q000502:physiology / Q000523:psychology*; D013315:Stress, Psychological / Q000503:physiopathology / Q000523:psychology*