Menopause Knowledge and Subjective Experience Among Peri- and Postmenopausal Women With Bipolar Disorder, Schizophrenia and Major Depression

Abstract

This study examined concerns regarding menopause among women with schizophrenia/schizoaffective disorder (N = 30), women with bipolar disorder (N = 25), and women with major depression (N = 36). The three groups were compared regarding knowledge of menopause, expectations of effect of menopause, and menopause-related quality of life. All women had deficits in fund of knowledge regarding menopause. More than half (53.8%) agreed that they felt more stressed due to menopause or approaching menopause, and 51.6% felt that menopause has had a negative effect on their emotional state. Perceptions of menopause effect on emotional states between the three groups were similar. The top five symptoms experienced by women with serious mental illness were all problems related to psychological issues: feeling depressed (88%, N = 80), feeling anxious (88%, N = 80), feeling tired or worn out (87%, N = 79), feeling a lack of energy (86%, N = 78), and experiencing poor memory (84%, N = 76). Larger-scale studies evaluating the effects of menopause on serious mental illness are needed to clarify how menopause affects illness outcomes in women with serious mental illness.

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

“…For many women, stress and hormonal changes associated with the transition to menopause may increase or trigger mood symptoms 550, 551, 552. A post hoc analysis of the prospective Systematic Treatment Enhancement Program for Bipolar disorder (STEP‐BD) study showed increased rates of depressive, but not manic episodes during menopause transition 553.…”

Hormonal therapies for new onset and relapsed depression during perimenopause

“…The frequency of depressive but not manic episodes was increased compared with the woman's premenopausal years [32]. In a cross sectional study of women with bipolar disorder, MDD and schizophrenia (30 in each group), 51.6% of women reported worsened mood symptoms with menopause [33]. Payne conducted a cross sectional survey of 2412 women with MDD or BPD.…”

Reproductive Aging: Perimenopause and Psychopathological Symptoms

“…Last but not least, women with serious mental disorder have deficits in knowledge regarding menopause [53]. Therefore, educational programmes are necessary and should offer valuable information on natural course of perimenopause and strategies to alleviate perimenopausal symptoms, i.e.…”

“…Usually, women with a history of poor adaptation to stress or specific personality traits, particularly neuroticism, are predisposed to menopausal syndrome, with more than half of women feeling more stressed due to menopause or approaching menopause, and describing menopause as an unpleasant experience that has had a negative effect on their emotional state [43,53,56,57]. Research also showed that a later age of menarche carries more risk for psychiatric morbidity in perimenopause, because the exposure of women to neuroprotective and serotonin regulatory effects of estrogen is shorter [58].…”