Hormonal substitution during menopause: what are we treating?

L W Maartens¹, G L Leusink, J A Knottnerus

¹Diagnostic Centre Eindhoven, The Netherlands.

|March 14, 2000

Summary

Hormone replacement therapy (HRT) may not effectively treat non-vasomotor menopausal symptoms. Underlying depression significantly impacts these complaints, suggesting alternative treatments may be more beneficial.

Area of Science:

Reproductive Medicine
Psychiatry
Epidemiology

Background:

Menopausal transition is associated with various symptoms, including vasomotor, urogenital, and cognitive-vegetative complaints.
Hormone replacement therapy (HRT) is commonly considered for menopausal symptoms, but its efficacy for non-vasomotor complaints is debated.
Underlying depressive symptoms may coexist with or contribute to menopausal complaints.

Purpose of the Study:

To investigate the relationship between menopausal complaints and depressive symptoms in a large cohort of Dutch women.
To assess the impact of hormone replacement therapy (HRT) and oral contraceptive use on menopausal symptom scores.
To determine the contribution of depressive symptoms to the variance in menopausal complaint scores.

Main Methods:

Cross-sectional study of 5896 Dutch Caucasian women aged 47-54.
Menopausal complaints assessed using a 22-item self-rating scale with vasomotor, urogenital, and cognitive-vegetative subscales.
Depressive symptoms measured using the Edinburgh Depression Scale (EDS); data analyzed with ANOVA and multiple linear regression.

Main Results:

Women using HRT reported the highest scores across all menopausal symptom subscales.
Oral contraceptive users had significantly lower vasomotor symptom scores compared to HRT users and non-users.
Depressive symptoms were the most significant contributor to the explained variance in menopausal complaint scores.

Conclusions:

Menopausal complaints beyond vasomotor symptoms may indicate underlying depression.
Prescribing HRT for cognitive-vegetative or other non-vasomotor menopausal symptoms is questionable.
Identifying and treating underlying depression is crucial for managing complex menopausal symptom profiles.

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