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Depression in Women ,How can I cope with symptoms of menopause?

There are many ways you can ease menopause symptoms and maintain your health. These tips include ways to cope with mood swings, fears, and depression:
  • Eat healthfully and exercise regularly.
  • Engage in a creative outlet or hobby that fosters a sense of achievement.
  • Find a self-calming skill to practice -- such as yoga, meditation, or slow, deep breathing.
  • Keep your bedroom cool to prevent night sweats and disturbed sleep.
  • Seek emotional support from friends, family members, or a professional counselor when needed.
  • Stay connected with your family and community and nurture your friendships.
  • Take medicines, vitamins, and minerals as prescribed by your doctor.
  • Take steps such as wearing loose clothing to stay cool during hot flashes.

How is depression in women treated?

There are a variety of methods used to treat depression, including medications such as antidepressants and psychotherapy. Antidepressants carry a boxed warning about the increased risk of suicidal thinking or suicidal behavior by children, adolescents, and young adults taking tham. All people taking antidepressants should be closely monitored. Changes such as worsening depression, suicidal thinking or behavior, agitation, sleep problems, or withdrawal from normal social activity should be reported to your health care provider.
Family therapy may be helpful if family stress adds to your depression. Your mental health care provider will determine the best course of treatment for you. If you are uncertain who to call for help with depression, check out the following list from the National Institute of Mental Health:
  • community mental health centers
  • employee assistance programs
  • family doctors
  • family service/social agencies
  • health maintenance organizations
  • hospital psychiatry departments and outpatient clinics
  • local medical and/or psychiatric societies
  • mental health specialists such as psychiatrists, psychologists, social workers, or mental health counselors
  • private clinics and facilities
  • state hospital outpatient clinics
  • university or medical school affiliated programs Menopause is the normal change from the child bearing years to the next phase in your life.  At menopause your menstruation, or period, has not flowed for 12 months because your ovaries are making less of the “female hormones”, estrogen and progesterone, as well as less of the “male hormones”, such as testosterone.  Menopause usually occurs between the ages of 45 and 55, with the average age of onset being 51.  Premature (early) menopause can result from certain health problems or surgical removal of the ovaries.  For most women menopause is a natural change, and it is a good time to look closely at your health habits.
    While your body gets use to lower hormone levels you may experience symptoms.  Some women also have symptoms up to 10 years prior to menopause.  This time is called perimenopause.  Common problems are:
    Hot flashes are experienced by over 80% of women.  They are described as a sudden warmth or intense heat, with flushing and/or sweating, which spreads over the body, and may be followed by chills.  If they occur at night they may interfere with sleep.  They may be uncomfortable, but they are not dangerous.  They usually ease over 6 to 24 months. Common triggers for hot flashes include stress, overheating, tight clothing, hot beverages, spicy foods, alcohol, caffeine and cigarette smoking.
    Mood changes, such as feeling sad or blue, nervous and irritable.  If these symptoms are due to menopause they will be temporary, although they may be made worse by the stress and sleep problems many women experience at this time of life. Mood changes are not the same as depression. Other health problems may produce similar symptoms.
    Fatigue, feeling weary or tired.  This could also be due to poor sleep from hot flashes.
    Vaginal dryness and thinning of the vagina (birth canal) and surrounding area.  This may result in vaginal irritation, itching, infections, pain with sex, and leakage of urine (incontinence).
    menopauseOsteoporosis and Heart disease.  Some women are at increased risk for these diseases after menopause.
    Although the catalogue of potential symptoms seems daunting, there are many integrative modalities available that may provide relief.  This life transition is a good time to discuss your symptoms and review your possible risks for future health problems with your health care provider.
    Every woman’s needs are different, but we can all find common ground in the need to build a foundation of healthy lifestyle habits. Pay attention to your physical, mental, emotional and spiritual health.  Begin with the basics.  Design a regular exercise routine that you enjoy, manage your stress and commit to getting 7 to 9 hours of sleep a night.  Be sure your diet has plenty of fruits and vegetables (especially berries and dark, green leafies), and contains adequate amounts of lean protein and the healthy fats, such as is found in olive oil, avocado, nuts, seeds; as well as the omega 3 essential fatty acids found in cold-water oily fish, soy, walnuts, almonds, hemp seed, chia, sesame or flax seeds, and dark green leafy vegetables.  Avoid caffeine and alcohol, or limit your use to no more than one serving a day, reduce or largely eliminate sugar and refined/processed carbohydrates, and quit smoking.
    Discuss with your health care provider the value of supplements. You may derive benefit from select nutraceuticals, such as a comprehensive multivitamin, anti-oxidant and mineral complex, calcium, magnesium, vitamin D3, B vitamin complex, full-spectrum vitamin E complex (tocopherols and tocotrienols), fish oil, and a source of GLA–hemp oil, borage oil, evening primrose oil or black current oil.
    There are many botanical therapies with potential to relieve your symptoms and improve your health.  Phytoestrogens are plant substances that are structurally similar to animal estrogens. In some studies they have demonstrated an ability to reduce menopause symptoms, and exert a positive effect on bone and heart health.  Isoflavones and lignans are two families of useful phytoestrogens.  Isoflavones can be found in soy foods and in red clover.  They are best consumed in whole foods, as opposed to isolated extracts.  Flax, chia, hemp and sesame seed are some sources of lignans.  Herbs that may have benefit include Siberian rhubarb root, maca, black cohosh, chaste berry, dong quai and damiana.  St. John’s Wort, valerian, Holy Basil and other herbs may help ease mood changes and sleep disturbances.  Other therapeutic interventions to explore include organic therapeutic grade A essential oils, and targeted amino acid therapy. In addition, conventional medicine has some pharmaceuticals that demonstrate efficacy. To obtain the maximum benefit from any approach discuss the proper dose, product quality, and appropriate trial period with your health care provider. Since we are all individuals, it is possible that you will need to give yourself some time to find the right combination of lifestyle modifications and other interventions.
    Hormone therapy (HT) is currently used to relieve the symptoms of menopause and to strengthen bones. The most common form of HT is a horse estrogen product called Premarin, combined with a synthetic (man-made) progesterone-like molecule called a progestin (Provera is a well-known product).  Sometimes these cause irritating side effects, and the estrogen, or progestin combined with estrogen, can be harmful to some women.  Current standards state that most women with a history of breast cancer or heart disease should not use estrogen.  If you and your provider decide that HT is your best option you should ask for the lowest dose that works for you.  Also consider the use of  “natural” (bio-identical) estrogens and progesterone in the form of pills, patches, suppositories or skin creams.  Some women successfully treat their symptoms using only the bio-identical progesterone.  These hormones are still formulated in the laboratory, but they are chemically the same as the human hormone.  At one time a compounding pharmacy was your only source for bio-identical hormones, but pharmceutical companies now produce bio-identical estrogens, and an oral bio-identical progesterone product called Prometrium. Discuss the pros and cons of an oral progesterone with your health care provider if you are experiencing difficulty with sleep and/or anxiety, as this method of delivery may result in more sedation.
    Regular sexual intercourse will help maintain the moisture and tone of the vagina.  Products that ease vaginal dryness and irritation are vaginal bio-identical estriol or estradiol, Replens, Astroglide, other lubricant jellies, vitamin E oil, vitamin E suppositories, and aloe vera gel applied around the opening of the vagina.
    Options for stress management may include prayer, yoga, meditation/mindfulness, breath work, guided visualization/hypnotherapy, massage, acupuncture, and regular exercise.
    Consider exploring other therapeutic traditions, such as Energy work, Homeopathy, Traditional Chinese Medicine, and Ayurveda.
    Finally, honor this time and yourself.  Stretch your mind, express your creativity, and share your wisdom.  Value your maturity! Be well.
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