The Correlations Between Sex Hormones And Permenopausal Depression

OBJECTIVE:To explore the correlations between serum estralio, testosterone levels, and perimenopause depression, and to clarify the clinical feature of perimenopause depression.METHODS:To adopt Case-Control study. we collected 40 women with perimenopausal depression as case group and 40 healthy women as control group, to assess the severity of depression by Hamillon depression rating scale(HAMD) and incidence rate by symptoms scale. All the subjects were assigned to four subgroups according to different menstruation situation:menopausal transition period case and control, postmenopausal case and control.40 women with perimenopausal depression (case group) were assigned to subgroup with vascular symptoms and subgroup without vascular symptoms according to presence or absence of flushes. Electrochemiluminescence immunoassay (ECLIA) was used to measure the levels of the estralio(E2) and testosterone(T).RESULTS:(1). The level of E2 in case group was significantly lower than that in control group (P<0.01), and had negative correlations with HAMD (P<0.01); In both the menopausal transition period and the postmenopause period, the levelof E2 in case group was lower that in the matched control groups(P<0.05, P<0.01).(2). The level of T in case group was significantly higher than that in control group (P<0.01), and had the same finding between menopausal transition period 'case and control(P<0.01), but had no significant differences between postmenopause'caseand control (P>0.05). Furthermore, no association could be detected between the level of T and HAMD in case group (P>0.05)(3).The E2/T in case group and control group had significant differences (P< 0.01).(4)The level of T in subgroup with vascular symptoms is higher than that in subgroup without vascular symptoms (P<0.01), but the difference about E2 between two subgroups is not statistically signifcant (P>0.05)(5) In case group,40 patients had blue mood (100%) and drop interest (100%), 37 patients had somatization symptom (92%),22 patients had lack of sexual desire (55%),32 patients had anxiety (80%),31 patients had sleep disturbance (76%),30 patients had changed appetite (75%),29 patients had agitation (73%),15 patients had suicide ideation (38%),15 patients had weight changes (38%),13 patients had retardation (32%).(6) HAMD scale:anxiety/somatization (2.81±0.24), cognitive disturbance (2.57±0.53), retardation (1.34±0.63), sleep disturbance (1.97±0.14), weight (1.17±0.47).CONCLUSIONS:(1)The Serum estradiol level of women with perimenopausal depression is significantly lower. The estradiol level is more lower, and the depressive symptom is more serious. To suggest that lower estradiol is a risk factor of perimenopausal depression.(2)The serum testosterone level of women with perimenopausal depression were significantly higher. Higher testosterone may be a risk factor of vascular symptoms, which is usually called somatic anxiety.(3) The imbalance of the ratios of sex hormones is a risk factor for perimenopausal depression.(4)Perimenopausal depression were mostly charactered by somatization symptom, anxiety, agitation and sleep disturbance, but retardation was less common. To suggest that the clinical characters of perimenopausal depression and endogenous depression are different.