scholarly journals Testosterone and depressive symptoms during the late menopause transition

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Bethany Sander ◽  
Amira Muftah ◽  
Laurie Sykes Tottenham ◽  
Julia A. Grummisch ◽  
Jennifer L. Gordon
Keyword(s):  
Depressive Symptoms ◽  
Sleep Quality ◽  
Vasomotor Symptom ◽  
Vasomotor Symptoms ◽  
Pronounced Increase ◽  
Testosterone Levels ◽  
Symptom Bother ◽  
Increased Risk ◽  
Perimenopausal Women ◽  
Menopause Transition

Abstract Background The menopause transition is associated with an increased risk of depression. While the mechanisms behind this increased risk are not well understood, the changing perimenopausal hormonal environment has been hypothesized to play a role. The current study examined the potential influence of testosterone and the ratio of testosterone to estradiol as a potential contributor to depressed mood in the menopause transition. Methods Fifty non-depressed perimenopausal women ages 45–55 were recruited for this study. Once every 3 weeks, for a total of four times, the women completed the Centre for Epidemiological Studies-Depression (CES-D) scale for the measurement of depressive symptoms and provided a first-morning urine sample for the measurement of urinary testosterone as well as estrone-3-glucuronide (E1G), a urinary metabolite of estradiol. The week-to-week and mean effects of testosterone, E1G, and the testosterone/E1G ratio on CES-D score were examined. Self-reported sleep quality and vasomotor symptoms were also assessed at each of the four time points. Results Testosterone levels rose with increasing months since last menstrual period associated with testosterone levels (β(SE) = 175.3(63.2), p = .006), though this effect was moderated by body mass index (p for the interaction = .001) such that overweight women showed a less pronounced increase over time. Past and current smokers also had higher testosterone levels compared to never smokers. Week-to-week testosterone/E1G ratio was positively associated with CES-D score (β(SE) = 1.57(0.76), p = .041) but not sleep quality or vasomotor symptoms (ps > .05). Mean testosterone/E1G ratio was also positively associated with vasomotor symptom bother (β(SE) = 0.14(0.06), p = .018) and poorer sleep quality (β(SE) = − 0.34(0.09), p = .0001). Conclusion These results suggest that, within the context of the menopause transition, times that are characterized by a higher testosterone-to-estradiol ratio may be associated with higher depressive symptoms. Perimenopausal women with a higher average ratio of testosterone relative to estradiol may also experience more sleep difficulties and vasomotor symptom bother.

scholarly journals Impact of Estradiol Variability and Progesterone on Mood in Perimenopausal Women With Depressive Symptoms

2019 ◽  
Vol 105 (3) ◽  
pp. e642-e650 ◽  
Author(s):  
Hadine Joffe ◽  
Anouk de Wit ◽  
Jamie Coborn ◽  
Sybil Crawford ◽  
Marlene Freeman ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Stressful Life Events ◽  
Rating Scale ◽  
Depressive Symptomatology ◽  
Medical Center ◽  
Academic Medical Center ◽  
Madrs Score ◽  
Increased Risk ◽  
Perimenopausal Women ◽  
Menopause Transition

Abstract Context Women are at increased risk for depressive symptoms during the menopause transition. Changes in estradiol secretion and presence of vasomotor symptoms (VMS) contribute to perimenopausal depressive symptoms, but links with progesterone have not been investigated. Objective To determine whether estradiol variability, ovulatory levels of progesterone, and VMS burden are independently associated with perimenopausal depressive symptomatology. Design and Intervention Depressive symptoms, serum levels of estradiol and progesterone, and VMS frequency were assessed weekly in an 8-week observational study. Association of mood with estradiol variability, ovulatory levels of progesterone, and VMS frequency were estimated using generalized estimating equation models. Setting Academic medical center. Patients Fifty unmedicated perimenopausal women with mild-to-moderate depressive symptoms (mean Montgomery-Åsberg Depression Rating Scale [MADRS] score 15.5 ± 5.3). Main Outcome Measure Depressive symptoms (MADRS score). Results During the study, 90.0% of participants had varying estradiol levels, 51.1% had ovulatory progesterone levels, and 90% had VMS. Greater estradiol variability and absence of progesterone levels consistent with ovulation, but not VMS frequency, are associated with higher levels of depressive symptoms (β = 0.11 [95% confidence interval (95% CI), 0.04 to 0.18; P = 0.001]; β = −2.62 [95% CI, −4.52 to −0.71; P = 0.007], respectively), after accounting for higher body mass index, lifetime history of depression, and stressful life events. Conclusions Increasing dysregulation of ovarian hormones, but not VMS, associates with more depressive symptom burden during perimenopause. These results suggest that perimenopausal mood instability is driven by the underlying hormonal dysregulation of the menopause transition involving changes in both estradiol and progesterone.

scholarly journals The influence of subjective sleep quality on the association between eveningness and depressive symptoms.

2018 ◽  
Author(s):  
Charlotte Mary Horne ◽  
Ray Norbury
Keyword(s):  
Depressive Symptoms ◽  
Sleep Quality ◽  
Mediation Analysis ◽  
Depression Scale ◽  
Well Being ◽  
Poor Sleep ◽  
Subjective Sleep Quality ◽  
Subjective Sleep ◽  
Increased Risk ◽  
Healthy Participants

Increasing evidence suggests that eveningness is associated with increased risk for depression. Eveningness, however, is also associated with poor sleep quality and the unique role of eveningness in depressive symptomatology remains to be elucidated. The goal of the current study, therefore, was to examine the inter-relationships between eveningness, subjective sleep quality and depressive symptoms in healthy participants free of current or previous depression and sleep disorder. Here, 167 healthy participants (mean age 24.16, 129/38 females/males) completed the reduced Morningness-Eveningness Questionnaire (rMEQ), the Pittsburgh Sleep Quality Index (PSQI) and the Centre for Epidemiological Studies Depression Scale (CES-D). Bootstrap mediation analysis for a simple mediation model including rMEQ, PSQI and CES-D was applied. Eveningness was associated with increased depressive symptoms and mediation analysis showed that this relationship was partly mediated by sleep quality. Our results suggest that indicators of depression observed in evening-type individuals cannot be attributed exclusively to disturbed sleep. We suggest that interventions that target both sleep quality and dysfunctionl cognitive styles would be optimal to promote well-being in evening-type individuals.

scholarly journals Associations of Tryptophan, Docosahexaenoic Acid (DHA), and Vitamin D With Sleep Quality and Depression During Pregnancy

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 766-766
Author(s):  
Amber Kautz ◽  
Ying Meng ◽  
Emily S Barrett ◽  
Jessica Brunner ◽  
Richard Miller ◽  
...  
Keyword(s):  
Vitamin D ◽  
Depressive Symptoms ◽  
Docosahexaenoic Acid ◽  
Sleep Quality ◽  
Pregnant Women ◽  
Maternal Mental Health ◽  
Smoking Status ◽  
Depression Scale ◽  
Poor Sleep ◽  
Increased Risk

Abstract Objectives During pregnancy women are at increased risk of poor sleep quality and depression. Serotonin and melatonin are compounds that are involved in regulation of sleep and mood. Several nutrients are involved in the synthesis of these compounds, including tryptophan, docosahexaenoic acid (DHA), and vitamin D. Studies exploring associations between these nutrients and sleep, as well as mood, have been largely limited to the general population, showing mixed results. The aim of this study was to assess the associations of dietary intake of these nutrients with sleep quality and depression in pregnant women. Methods Participants enrolled in the Understanding Pregnancy Signals and Infant Development (UPSIDE) Study (n = 253) were included in this analysis if they completed dietary, sleep and depression assessments during the 2nd trimester. Dietary and supplement intake were measured using 24-hour dietary recalls. The NCI method was used to estimate usual intake. Sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI). Depressive symptoms were measured with the Edinburgh Postnatal Depression Scale (EPDS). Multivariable linear regression was conducted to estimate the associations between nutrients and sleep/depression, adjusting for age, race/ethnicity, parity, education, early pregnancy body mass index, smoking status, energy and macronutrient intake. Results The NCI adjusted mean intakes of tryptophan, DHA, and vitamin D were 1.02 ± 0.11 g/day, 0.13 ± 0.11g/day, and 19.74 ± 21.80 mcg/day, respectively. Mean PSQI score was 6.15 ± 3.39, where higher scores indicated worse sleep quality, and mean EPDS score was 5.84 ± 4.77, where higher scores indicated increased severity of depressive symptoms. Tryptophan intake was inversely associated with EPDS scores (b = −15.23, 95%CI: −26.75, −3.72). The associations between DHA, vitamin D, and depression were not significant. The selected nutrients were not associated with PSQI scores. Conclusions In this study, higher tryptophan intake was associated with lower depressive symptoms among pregnant women during the second trimester. Additional research on the relationship between tryptophan intake and maternal mental health during pregnancy is warranted. Funding Sources NIH, Mae Stone Goode Foundation, Wynne Family Foundation.

scholarly journals Independent Contributions of Nocturnal Hot Flashes and Sleep Disturbance to Depression in Estrogen-Deprived Women

2016 ◽  
Vol 101 (10) ◽  
pp. 3847-3855 ◽  
Author(s):  
Hadine Joffe ◽  
Sybil L. Crawford ◽  
Marlene P. Freeman ◽  
David P. White ◽  
Matt T. Bianchi ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Sleep Quality ◽  
Sleep Disturbance ◽  
Univariate Analysis ◽  
Hot Flashes ◽  
Sleep Disruption ◽  
Serum Estradiol ◽  
Subjective Sleep Quality ◽  
Subjective Sleep ◽  
Increased Risk

Context: Women are at increased risk for mood disturbance during the menopause transition. Hot flashes (HFs), sleep disruption, and fluctuating estradiol levels correlate with menopause-associated depression but co-occur, making cause and effect relationships difficult to disentangle. Objective: Using a GnRH agonist (GnRHa) experimental model, we investigated whether depressive symptoms are associated with HFs and/or are explained by concomitant sleep fragmentation in the absence of estradiol fluctuation. Design and Intervention: Depressive symptoms, objective polysomnographic sleep parameters, subjective sleep quality, serum estradiol, and HFs were assessed before and 4 weeks after open-label depot GnRHa (leuprolide 3.75-mg) administration. Setting: Academic medical center. Participants: Twenty-nine healthy nondepressed premenopausal volunteers (mean age, 27.3 years). Results: Serum estradiol was rapidly and uniformly suppressed. HFs developed in 69% of the subjects. On univariate analysis, worsening of mood was predicted by increases in time in light sleep (stage N1), number of transitions to wake, non-REM arousals, subjective sleep quality, and reductions in perceived sleep efficiency (all P < .045), as well as the number of nighttime (P = .006), but not daytime (P = .28), HFs reported. In adjusted models, the number of nighttime HFs reported, increases in non-REM arousals, time in stage N1, transitions to wake, and reduced sleep quality remained significant predictors of mood deterioration (P ≤ .05). Conclusions: Depressive symptoms emerged after estradiol withdrawal in association with objectively and subjectively measured sleep disturbance and the number of nighttime, but not daytime, HFs reported. Results suggest that sleep disruption and perceived nighttime HFs both contribute to vulnerability to menopause-associated depressive symptoms in hypoestrogenic women.

scholarly journals 1084 Depression and Stress Generation: Can Sleep Quality Bridge the Gap?

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A413-A413
Author(s):  
C Summers ◽  
J Ciesla ◽  
C Bean
Keyword(s):  
Depressive Symptoms ◽  
Sleep Quality ◽  
Structural Equation ◽  
Stressful Life Events ◽  
Stressful Events ◽  
Stress Generation ◽  
Future Research ◽  
Increased Risk ◽  
Depressive Episodes ◽  
Sleep Difficulties

Abstract Introduction The stress generation literature has established a bidirectional relationship between depression and stress. Not only do stressful life events predict depressive episodes, but a depressive history is also linked to increased, future stressors. One relevant mechanism that has received little attention to account for this relationship is sleep. Sleep difficulties are intertwined with depression, both as a predictive and maintenance factor. Beyond depression, sleep disruption is also a factor in a plethora of stressful events, from an increased risk of automotive accidents to higher reports of interpersonal conflict. The present study explored the role of sleep quality to account for depression’s association with stressors. Methods Ninety-six college students (Age: M = 19.56, SE = .20) reported on their depressive symptoms before undergoing a two-week, online diary, where they reported on sleep quality and the number of stressors experienced. A generalized structural equation model (GSEM) was used to test the relevance of sleep quality to account for baseline depressive symptoms predicting average differences in stressors over the diary. Within the GSEM, a multilevel model was used to explore the daily, within-person association between sleep quality and the number of stressors reported. Results Baseline depression was predictive of poorer sleep quality (b = .01, p < .001) and more stressors across the diary (b = .02, p = .017). Sleep quality mediated the effect of depression on stress generation (b = .002, p = .036), accounting for 13% of the variance. On a daily level, poorer sleep quality the night before predicted more stressors the next day (b = .16, p = .027). Conclusion The results suggest that sleep quality is a relevant mechanism in the prediction of future stressors from depression. Sleep difficulties may represent a pivotal area of future research and intervention target in breaking the cycle between depression and stress generation. Support Hammen, C. (1991). Generation of stress in the course of unipolar depression. Journal of Abnormal Psychology, 100, 555-561. Tsuno, N., Besset, A., & Ritchie, K. (2005). Sleep and depression. The Journal of Clinical Psychiatry, 66, 1254-1269.

scholarly journals Effects of perimenopausal transdermal estradiol on self-reported sleep, independent of its effect on vasomotor symptom bother and depressive symptoms

Menopause ◽  
2019 ◽  
Vol 26 (11) ◽  
pp. 1318-1323 ◽  
Author(s):  
Paul J. Geiger ◽  
Tory Eisenlohr-Moul ◽  
Jennifer L. Gordon ◽  
David R. Rubinow ◽  
Susan S. Girdler
Keyword(s):  
Depressive Symptoms ◽  
Vasomotor Symptom ◽  
Symptom Bother ◽  
Transdermal Estradiol

Does exercise improve self-reported sleep quality in non-remitted major depressive disorder?

2012 ◽  
Vol 43 (4) ◽  
pp. 699-709 ◽  
Author(s):  
C. D. Rethorst ◽  
P. Sunderajan ◽  
T. L. Greer ◽  
B. D. Grannemann ◽  
P. A. Nakonezny ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Symptoms ◽  
Depressive Disorder ◽  
Sleep Quality ◽  
Sleep Onset ◽  
Early Morning ◽  
Depression Severity ◽  
Major Depressive ◽  
Exercise Treatment ◽  
Increased Risk

BackgroundSleep disturbances are persistent residual symptoms following remission of major depressive disorder (MDD) and are associated with an increased risk of MDD recurrence. The purpose of the current study was to examine the effect of exercise augmentation on self-reported sleep quality in participants with non-remitted MDD.MethodParticipants were randomized to receive selective serotonin reuptake inhibitor (SSRI) augmentation with one of two doses of exercise: 16 kilocalories per kilogram of body weight per week (KKW) or 4 KKW for 12 weeks. Depressive symptoms were assessed using the clinician-rated Inventory of Depressive Symptomatology (IDS-C). The four sleep-related items on the IDS-C (Sleep Onset Insomnia, Mid-Nocturnal Insomnia, Early Morning Insomnia, and Hypersomnia) were used to assess self-reported sleep quality.ResultsSignificant decreases in total insomnia (p < 0.0001) were observed, along with decreases in sleep onset, mid-nocturnal and early-morning insomnia (p's <0.002). Hypersomnia did not change significantly (p = 0.38). Changes in total, mid-nocturnal and early-morning insomnia were independent of changes in depressive symptoms. Higher baseline hypersomnia predicted a greater decrease in depression severity following exercise treatment (p = 0.0057). No significant moderating effect of any baseline sleep on change in depression severity was observed. There were no significant differences between exercise treatment groups on total insomnia or any individual sleep item.ConclusionsExercise augmentation resulted in improvements in self-reported sleep quality in patients with non-remitted MDD. Given the prevalence of insomnia as a residual symptom following MDD treatment and the associated risk of MDD recurrence, exercise augmentation may have an important role in the treatment of MDD.

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