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Date of release: 05 July, 2010

Symptoms of depression among pre-, peri- and postmenopausal women in Turkey


A community-based sample of 685 women, aged 45–59 years (mean 51 years) living in East Turkey, was recruited in this recently published, cross-sectional study by Timur and Sahin [1]. An information form that included questions on descriptive characteristics and lifestyle variables of cases, the Menopause-Specific Quality of Life Questionnaire, and the Beck Depression Inventory were administered to each woman in the sample. The data were collected through a personal interview with each woman at her home. The prevalence of depression symptoms among the perimenopausal and postmenopausal women was 41.8%. Of all the women, 23.2% were premenopausal and 56.9% were postmenopausal. Logistic regression analysis revealed that the development of depression symptoms was 1.8 times higher in the perimenopausal–postmenopausal period than in the premenopausal period, 3.6 times higher among those with an event history affecting life in a negative way, and 2.0 times higher among those with a body mass index of 25 kg/m2 or higher.

Comment

Timur and Sahin conducted a study in a hospital-based population in certain areas of Turkey and claimed that there was a high level (41.8%) of prevalence of depression symptoms in perimenopausal and postmenopausal women when compared with premenopausal women [1]. However, the study contains some major problems related to sample size, patient selection criteria, and definitions of perimenopause, postmenopause and premenopause. The authors also revealed that body mass index scores above 25 kg/m2 constituted a negative influencing factor for depression among those women. 
According to another recent article, 97.7% of women experienced a problem or had complaints during menopause, while 54.9% reported that they experienced problems in their sexual lives [2]. The frequency of depression symptoms in women living in an Eastern province of Turkey is very similar to the frequency in this study (42.2%). These prevelance rates are less than those reported in Western countries [3]. Although the use of hormone therapy in menopause significantly improves the depression symptoms [4], the acceptance rate for usage of hormone therapy among Turkish women is quite low [5]. The most important reason for resistance to hormone therapy during menopause is that Turkish women, especially those living in urban areas, regard menopause as a natural event which should not be subject to intervention by hormone therapy. The period of menopausal transition is perceived as special period of time in their lives that provides them with wisdom and finally prepares them for a higher status or position in the family. Therefore, the depression rate is relatively low. 
Overall, in my opinion, menopausal women in different countries should be regarded as having different characteristics according to their lifestyles. Therefore, the perceptions of both menopause and responses relating to it, namely hormone therapy, and of depression normally vary depending on these characteristics.

Comentario

Tamer Erel
Department of Obstetrics & Gynecology, Cerrahpaşa School of Medicine, İstanbul University, Turkey

    References

  1. Timur S, Sahin NH. The prevalence of depression symptoms and influencing factors among perimenopausal and postmenopausal women. Menopause 2010;17:545-51.
    http://www.ncbi.nlm.nih.gov/pubmed/20400922

  2. Deveci SE, Aik Y, Dag DG, Tokdemir M, Gndoğdu C. The frequency of depression and menopause-related symptoms in postmenopausal women living in a province in Eastern Turkey, and the factors that affect depressive status. Med Sci Monit 2010;16:PH40-7.
    http://www.ncbi.nlm.nih.gov/pubmed/20357730

  3. Seritan AL, Iosif AM, Park JH, et al. Self-reported anxiety, depressive, and vasomotor symptoms: a study of perimenopausal women presenting to a specialized midlife assessment center. Menopause 2010;17:410-15.
    http://www.ncbi.nlm.nih.gov/pubmed/20216277

  4. Somunkiran A, Erel CT, Demirci F, Senturk ML. The effect of tibolone versus 17β-estradiol on climacteric symptoms in women with surgical menopause: A randomized, cross-over study. Maturitas 2007;56:61-8.
    http://www.ncbi.nlm.nih.gov/pubmed/16831525

  5. Erel CT. Professional development in menopause, Turkey. Presented at the 8th European Congress on Menopause (EMAS), London, UK, May 1620, 2009.