title: Depressive symptoms and menopausal burden in the midlife.
abstract: OBJECTIVE
  The goal of this study was to assess whether menopausal symptoms were more common and/or more severe among women with depressive symptoms.
  
  
  METHODS
  A cross-sectional survey of 1358 women, ages 45-70, at two large integrated health plans (Seattle; Boston) was performed. Information on demographics, medical and reproductive history, medication use, menopausal experience and depressive symptoms (PHQ-8) were collected. Women taking HT were excluded. Logistic regression models adjusted for age and body mass index tested the associations between menopausal symptoms (hot flushes, night sweats, vaginal dryness and dyspareunia) and presence of moderate/severe depressive symptoms.
  
  
  RESULTS
  770 women were included; 98 (12.7%) had moderate/severe depressive symptoms and 672 (87.3%) had no/mild depressive symptoms. Women with moderate/severe depressive symptoms were almost twice as likely to report recent vasomotor symptoms (hot flashes and or night sweats) vs. women with no/mild depressive symptoms (adjusted odds ratio (aOR) 1.67, 95%CI 1.04-2.68), and to report them as severe (aOR 1.63, 95%CI 0.95-2.83). A higher symptom burden was observed despite the fact that 20% of women with moderate/severe depressive symptoms (vs. 4.6% no/mild depressive symptoms) were using an SSRI or SNRI, medications known to improve vasomotor symptoms. The percentage of women with menopausal symptoms, and the percentage with severe vasomotor symptoms were linearly associated with the depressive symptom score.
  
  
  CONCLUSIONS
  Depressive symptoms "amplified" the menopausal experience, or alternatively, severe vasomotor symptoms worsened depressive symptoms.
authors.affiliation: Group Health Center for Health Studies, Seattle, WA, USA. reeds@u.washington.edu
authors.forename: Susan D
authors.initials: SD
authors.lastname: Reed
authors.forename: Evette J
authors.initials: EJ
authors.lastname: Ludman
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Newton
authors.forename: Louis C
authors.initials: LC
authors.lastname: Grothaus
authors.forename: Andrea Z
authors.initials: AZ
authors.lastname: LaCroix
authors.forename: Larissa
authors.initials: L
authors.lastname: Nekhlyudov
authors.forename: Leslie
authors.initials: L
authors.lastname: Spangler
authors.forename: Luesa
authors.initials: L
authors.lastname: Jordan
authors.forename: Kelly
authors.initials: K
authors.lastname: Ehrlich
authors.forename: Terry
authors.initials: T
authors.lastname: Bush
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications* / Q000453:epidemiology; D004414:Dyspareunia / Q000150:complications / Q000453:epidemiology; D005260:Female; D019584:Hot Flashes / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D008593:Menopause / Q000502:physiology / Q000523:psychology*; D008875:Middle Aged; D016017:Odds Ratio; D017698:Postmenopause / Q000502:physiology / Q000523:psychology*; D013546:Sweating