A prospective study of the association between endogenous hormones and depressive symptoms in postmenopausal women.
OBJECTIVE
Across a woman's lifetime, variations in hormone levels are known to influence mood and well-being. Whether absolute or changes in hormone levels over time are associated with depression among postmenopausal women remains unclear.


METHODS
The Melbourne Women's Midlife Health Project is a longitudinal population-based study of women who were followed through the menopausal transition. This analysis is based on data collected from 138 postmenopausal women in years 11 and 13 of the study, who were assessed for the presence of depressive symptoms using the Center for Epidemiological Studies Depression Scale. Logistic regression models were developed to determine whether absolute or changes in hormone levels were associated with depression.


RESULTS
No significant associations were found between depressive symptoms and the absolute levels of sex hormone-binding globulin, testosterone, free androgen index, estradiol, free estradiol, or follicle-stimulating hormone (FSH). On the other hand, women with a decline in total serum estradiol over the 2-year period had a more than threefold increased risk of depressive symptoms (odds ratio, 3.5; 95% CI, 1.2-9.9). A large increase in FSH levels over this period was also associated with depressive symptoms (odds ratio, 2.6; 95% CI, 1.0-6.7). These associations remained even after adjustment for initial depression score, as well as a range of potential confounding factors.


CONCLUSIONS
Changes in estradiol and, to a lesser extent, in FSH levels are associated with an increased risk of depressive symptoms in postmenopausal women. These results further support a role for fluctuating rather than absolute hormone levels in depression in later life.
Ryan
Joanne
J
Department of Psychiatry, University of Melbourne, Royal Melbourne Hospital, Parkville, Victoria, Australia. jryan2@pgrad.unimelb.edu.au
Burger
Henry G
HG
Szoeke
Cassandra
C
Lehert
Philippe
P
Ancelin
Marie-Laure
ML
Henderson
Victor W
VW
Dennerstein
Lorraine
L
D000368:Aged; D003863:Depression / Q000097:blood*; D004958:Estradiol / Q000097:blood*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood*; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008875:Middle Aged; D016017:Odds Ratio; D017698:Postmenopause / Q000097:blood* / Q000523:psychology*
D004958:Estradiol; D005640:Follicle Stimulating Hormone