Menopause and depression. Clinical case.

Menopause is an emotional and physical challenge, and despite all the information available to us, it's difficult to trust and feel supported. And at this stage, there is a risk factor for developing depression.

The relationship between menopause and depression is complex and multifactorial. Menopause is a stage in a woman's life that marks the cessation of menstruation, generally around age 50. During menopause, hormone levels, particularly estrogen, decline significantly. This hormonal transition can influence the mental and emotional health of some women, although not all experience negative effects on their mental well-being.

At beDona, we want to help you through personalized support tailored to your needs. Dr. Elisa Llurba, gynecologist, obstetrician, and director of beDona, shares a clinical case of menopause and depression in today's article.

Lara

Current symptoms:

A 52-year-old patient with no prior medical history, a smoker of 5 cigarettes per day, presents following menopause at age 50. She exhibits symptoms consistent with menopause, including hot flashes, impaired concentration and memory, and worsening sleep. She feels very weak, lacking energy and motivation, and has even had to reduce her working hours because she feels overwhelmed and constantly tired. She used to exercise, but due to fatigue and joint pain, she has gradually stopped and now walks about 4-5 km per day. She has gained 6 kg since menopause, primarily around her waist, and reports a change in her body type.
She went to her GP who diagnosed her with depression and she has been on antidepressant treatment for 6 months without noticing significant improvement.
Hormone treatment has not been considered because she was told that menopause is a natural process and not necessary.

During the beDona visit we assessed:

Lifestyle habits: She has a diet rich in carbohydrates, as she often eats a plate of pasta or rice, few proteins, she usually eats a lot of fruit, and she abuses coffee (she has to drink 3-4 a day because otherwise she gets sleepy).
She usually goes to sleep Around 12 o'clock, she falls asleep watching television, wakes up several times, and has trouble falling back asleep.
It doesn't regular exercise although he walks 4-5 km a day.
It has quite a lot stress She's been struggling at work and has reduced her hours because of it. She feels socially isolated because she finds it difficult to explain what's happening to her coworkers and her husband, who doesn't understand this change in personality. Her children are grown and have their own lives.

EXPLORATION:

Overweight, body mass index 27. Predominance of abdominal fat.
TA 119/74 FC 63x'.

Following the functional visit, we assessed the following THERAPEUTIC PLAN:

HORMONE THERAPY:
1. Transdermal estradiol patches are recommended because topical treatment does not increase the risk of blood clots, which is especially important for overweight women and smokers like Lara.
2. Micronized progesterone taken orally to counteract the effect of estrogens on the endometrium (the inner lining of the uterus) at night, which will help you sleep better.
FULL MENOPAUSE PROGRAM: Group therapeutic intervention to implement lifestyle changes: anti-inflammatory diet, exercise, meditation, pelvic floor, sleep hygiene and psychological support.

RESULTS:

Three months later, Lara is feeling much better. The hot flashes have disappeared, she sleeps through almost every night, and above all, she feels more energetic and vibrant. Her joint pain has stopped, and thanks to resuming exercise and following the diet recommended in the program, she has lost 6 kg and is much less bloated. She is considering returning to work full-time.

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If you would like one of our professionals to assess your case, you can schedule an individual visit at beDona.

If you want to know more about menopause and depression, we encourage you to read the article “Menopause and depression”

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