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Aging: Menopause Interventions for "The Change"
Menopause continuing education social worker CEUs

Section 11
Menopause: Four Links to Depression, Libido, and Memory Loss

CEU Question 11 | CEU Answer Booklet | Table of Contents | Geriatric & Aging
Social Worker CEUs, Psychologist CEs, Counselor CEUs, MFT CEUs 

a) Life-long depression and financial hardship may lead to early menopause, according to two recent studies. Women with a lifetime history of depression were 20 percent more likely to experience early perimenopause, a precursor to menopause, according to a report in the Archives of General Psychiatry. Depression itself may staunch the production of hormones, according to Bernard Harlow, M.D., of Brigham and Women's Hospital.

Women who lived through extended periods of economic hardship were also more likely to begin this physical transition earlier, according to a report published in the Journal of Epidemiology and Community Health. Lauren Wise, a doctoral student at Harvard University, speculates that stress, poor nutrition or toxins such as lead or tobacco smoke accelerate the rate at which eggs are depleted. Egg depletion is a known trigger of perimenopause.

Perimenopause is heralded by changes in a woman's menstrual cycle and may include menopausal symptoms such as hot flashes.
b) Declining estrogen may be associated with increased risk of depression. In a study in the journal Maturitas, Dutch researchers tracked some 2,000 middle-aged women for several years, finding increasing rates of depression as the women moved from premenopause to perimenopause, and from perimenopause to postmenopause.
c) Women taking hormone replacement therapy (HRT) in the form of oral medication to combat declining libido from menopause may be more capable of achieving orgasm if they use skin patches instead, according to a report presented at the World Congress on Menopause. This is because orally administered medication passes through the liver soon after it is ingested, affecting women's levels of androgens and testosterone, hormones that play a role in female sexuality.
d) Hormone-replacement therapy may exacerbate memory loss that occurs with Alzheimer's disease. Working with maze-trained rats, Gary Wenk, Ph.D., of the University of Arizona, mimicked menopause by removing the animals' ovaries. He also simulated early Alzheimer's by chemically inducing low-level inflammation in their brains. Ovary removal alone had no effect on the animals' ability to remember mazes, even with HRT. But animals without ovaries showed increased memory loss under HRT. Wenk published the findings in Behavioral Neuroscience and suggests that the constant dose levels used in standard HRT may be partially to blame. "We should try to mimic the natural cycle of hormone fluctuation," he says.

Stats…Stats…Stats…Stats
The mean age at menopause is 51, but some women are in their 30s, and others in their 60s. Most are 40 to 58.
Average age at menopause hasn't changed for several centuries, despite increasing life expectancy.
Nine out of ten women experience perimenopause--a period of altered menstrual cycles--before menopause. Perimenopause typically lasts four years.
- Lovett, Richard; Menopause: four links to depression, libido, and memory loss; Psychology Today; Mar/Apr 2003; Vol. 36; Issue 2.

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Personal Reflection Exercise #4
The preceding section contained information about menopause and its link to depression, libido, and memory loss.  Write three case study examples regarding how you might use the content of this section in your practice.

Online Continuing Education QUESTION 11
According to research done by Wenk, what is the effect of hormone replacement therapy on memory? Record the letter of the correct answer the CEU Answer Booklet

 
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