The relationship between depression and sexual function in menopause period

Global prevalence of depression in menopausal women: A systematic review and meta-analysis

BACKGROUND

An association between the menopause and depression is widely reported. This review aims to determine the global prevalence of depression in menopausal women (this includes women in perimenopause and postmenopause).

METHODS

PubMed, Web of Science, Embase, and PsycINFO databases were systematically searched from database inception until March 1, 2024. Studies with validated methods for assessing the prevalence of depression in perimenopausal and postmenopausal women were included. Two authors independently extracted relevant data. Random effects meta-analysis and Meta-regression analysis were performed using Stata software.

RESULTS

Total of 55 studies (76,817 participants) were included in the review. A random effects model was used to calculate pooled prevalence. The pooled depression prevalence in menopausal women was 35.6 % (95 % CI: 32.0-39.2 %), with 33.9 % (95 % CI: 27.8-40.0 %) in perimenopausal women, and 34.9 % (95 % CI: 30.7-39.1 %) in postmenopausal women. Subgroup analyses indicated that region, screening tool, study design, and setting moderated the prevalence of depression. Meta-regression indicated that smaller sample sizes and poorer study quality were significantly associated with a higher prevalence.

LIMITATIONS

There was a high degree of heterogeneity across the included studies. Only articles published in English were included. There was significant publication bias in this meta-analysis. There is insufficient information about many risk factors of menopausal depression in current meta-analysis.

CONCLUSIONS

Depression is common among menopausal women worldwide. To reduce the negative impact of depression on health outcomes in menopausal women, regular screening and the availability of effective prevention and treatment measures should be made available for this population.

Sexual satisfaction of postmenopausal women: An integrative review

A prerequisite for interventions for sexual satisfaction in postmenopausal women is a clear, objective measurement of the concept. Despite the large number of studies on the sexual satisfaction of postmenopausal women, there is no clear definition of sexual satisfaction in menopause. This study was conducted to investigate the concept of sexual satisfaction in postmenopausal women. The present study was carried out using an integrated review of data obtained from secondary sources, utilizing Whittemore and Knafl's method of bibliographic search. A literature search was performed without any data limitations in journals and international databases. The primary inclusion criterion was relevance to sexual satisfaction in postmenopausal women. The full texts of all these articles were evaluated using the checklists of the MMAT and PRISMA. Data were analyzed using MAXQDA 10 software using a constant comparison method. Meaning units were identified and coded. The codes were classified into subgroups and categories according to the characteristics, antecedents, and consequences of sexual satisfaction in postmenopausal women. During the integrative review of the 62 articles and three books, 580 codes about sexual satisfaction in menopause were extracted. The codes were grouped into three main attributes, five main antecedents, and three main consequences of sexual satisfaction in postmenopausal women. Four attributes, symptoms, or components were identified for the concept. These attributes were as follows: Change in sexual objective and subjective dimensions of sexual satisfaction after menopause, conditional sexual consent, change in behavior, and sexual function. These dimensions distinguish sexual satisfaction in menopause from other conditions. The concept of sexual satisfaction in menopause is a subjective (emotional interaction) and objective (physical interaction) experience that is conditioned by the fulfillment of expectations and the reconstruction of sexual relations while also being influenced by the change in sexual capacity during menopause.

Prevalence of poor body image and its correlation with self-esteem and depression in middle-aged women

OBJECTIVE

This study aimed to determine the prevalence and predictors of poor body image and its influence on low self-esteem and depression in middle-aged women.

METHODS

The study was a cross-sectional survey of 372 women using a predesigned online questionnaire. Main outcome measures were mean scores on the nine-point body image scale (BIS) and prevalence of poor body image (BIS ≥ 10). Significant sociodemographic, physical and mental health predictors of BIS ≥ 10 were established using logistic regression analysis. Correlation of body image with self-esteem, assessed by Rosenberg's self-esteem scale, and depression, assessed by Beck's Depression Inventory, was established using Pearson's correlation coefficient and the odds ratios were determined using logistic regression analysis.

RESULTS

The mean scores obtained for body image were 5.52 (standard deviation 4.82) and the prevalence of BIS ≥ 10 was 17.4%. Significant predictors of poor body image were education status (0.59, 95% confidence interval [CI] = 0.39-0.89), body mass index (2.26, 95% CI = 1.12-4.55), social support structure (0.35, 95% CI = 0.16-0.79), diagnosis of mental illness (3.74, 95% CI = 1.31-10.66) and perception of menopause (positive vs. negative: 0.20, 95% CI = 0.07-0.55). Body image scores correlated with self-esteem (r = -0.46; 95% CI = -0.54 to -0.38) and depression (r = 0.59; 95% CI = 0.52-0.65). BIS ≥ 10 significantly increased the odds of low self-esteem (5.71; 95% CI = 2.66-12.26) and depression (11.25; 95% CI = 4.9-27.7).

CONCLUSIONS

The prevalence of poor body image in middle-aged women was 17.4%. This strongly correlated with low self-esteem and depression. A lower education status, higher body mass index, a negative perception of menopause, poor social support structure and a history of mental health diagnosis increased the odds of poor body image prevalence in middle-aged women.

Sexual Function and Mood Disorders Among Menopausal Women: A Systematic Scoping Review

BACKGROUND

Changes in sex hormones during menopause may have detrimental effects on a woman's sexual function and cause mood disorders. The treatment of both conditions is a challenge in gynecology.

AIM

To review the published literature on sexual function and mood disorders among peri- and postmenopausal women.

METHODS

The review is based on the methodological framework of scoping reviews. We searched electronic databases including Medline (PubMed), Scopus, Embase, and Web of Science (WoS). Publications that reported data about the relationship between sexual function and mood disorders among menopausal women were included in the review. The search was not subject to any limitation in terms of time or method.

OUTCOMES

The main outcome measures used for the review were sexual dysfunction and mood disorders.

RESULTS

We found 106 total records. After a full-text screening we included 19 studies from 1986 to 2020 based on various methodologies; the majority of the studies16 were cross-sectional. Investigations that addressed the symptoms of mood disorders and some domains of sexual function showed a close relationship between sexual dysfunction and mood disorders among menopausal women.

CLINICAL IMPLICATIONS

In clinical practice, it would be appropriate to screen women for at least one mood disorder or sexual dysfunction. If a woman suffers from either, it will be necessary to assess for a further disorder as well.

STRENGTHS & LIMITATIONS

The review was based on a detailed search of the published literature concerning mood disorders and sexual dysfunction among menopausal women compared to women of reproductive age. Despite the clinical importance of the subject, the number of studies eligible for inclusion in the review are rather small. Further investigation of the topic is clearly warranted.

CONCLUSIONS

While the association between sexual dysfunction and mood disorders appears to be bidirectional, future studies will have to investigate the specific mechanisms by which sexual dysfunction could lead to mood disorders (or vice versa). Future studies should specifically address sexual dysfunctions and attitudes of partners, BMI, family support, sleep, and multiparity. Azam Rahmani, Elahe Afsharnia, Julia Fedotova, Shirin Shahbazi, Arezoo Fallahi, Leila Allahqoli, Reza GhaneipoklGheshlagh, Sarah Abboud, Ibrahim Alkatout. Sexual Function and Mood Disorders Among Menopausal Women: A Systematic Scoping Review. J Sex Med 2022;19:1098-1115.

Prevalence and associated risk factors for sexual dysfunction among postmenopausal women: a study from Iran

BACKGROUND

Female Sexual Dysfunction (FSD) is a distressing condition linked to menopause. This study aimed to determine the prevalence and contributing factors for FSD among postmenopausal women.

METHODS

This was a cross-sectional study. A convenience sample of postmenopausal women attending a gynecology clinic in a teaching hospital affiliated with Tehran University of Medical Sciences was enrolled into the study. The Female Sexual Function Index (FSFI) was used to assess sexual function. In addition, demographic and psychosocial information were recorded. The association between sexual function and anxiety and depression were examined to explore the data.

RESULTS

In all 162 postmenopausal women were studied. We performed general linear regression analysis to assess the relationship between sexual function and anxiety while including demographic variables in the model. The results showed that the model could explain about 46% of the variance observed in sexual function (adjusted R2 = 0.467). The analysis indicated that among independent variables, age (p <  0.001), sexual frequency (p <  0.001), and anxiety (p = 0.003) were significant contributing factors associated with sexual function. A similar analysis evaluating the relationship between sexual function and depression in menopausal women found that age (p <  0.001), sexual frequency (p <  0.001), and depression (p = 0.003), were significant contributing factors associated with sexual function; explaining about 46% of the variance observed (adjusted R2 = 0.466).

CONCLUSION

The findings showed that nearly half of menopausal women had sexual dysfunction in this convenience sample of women seeking gynecologic care. Women reporting sexual dysfunction also reported a higher prevalence of anxiety and depression. Indeed, recognition of such factors requires a holistic therapeutic approach to sexual dysfunction among postmenopausal women.

Cross-sectional study on the impact of age, menopause and quality of life on female sexual function

We sought to determine the prevalence of female sexual dysfunction (FSD) and to examine the influence of age, menopausal state and quality of life (QoL) on the female sexual function (FSF) of healthy women and those with benign gynaecological disease. With this purpose, we conducted a cross-sectional study, based on self-report questionnaires (sociodemographic, WHOQOL-BREF and FSFI), enrolling 107 women. Some 51.6% (n = 55) were diagnosed with FSD. We found no statistical significant differences between grouped reason for consultation and FSFI total score (p = .72) and its domains (p > .05). The results showed a negative strong correlation between age and FSFI total score (S= -0.71) and a positive moderate correlation between WHOQOL-BREF and FSFI total scores (S = 0.39). We observed statistically significant differences between menopausal state and FSFI total score (p = .001). In conclusion, the prevalence of FSD in our population was 51.6%. Our study results reveal that a reduction in FSFI scores has a negative impact on QoL and vice versa, regardless of the reason for consultation. Elderly age and postmenopausal state have deleterious effects on FSF.Impact statementWhat is already known on this subject? Poor QoL can adversely affect FSF and vice versa. The study of FSF is relatively recent and there is controversy regarding the deleterious effects of elderly age and menopause on FSF. The prevalence of FSD is difficult to precisely determine, given the studies' use of different definitions for FSD and the highly heterogeneous study populations, as well as the types of tests and questionnaires employed. Sexual difficulties are problems seldom discussed between patients and their physicians. Lack of time, misconceptions, shame and frustration, considering sexuality as too intimate to discuss in the doctor's office, uncertainty regarding therapeutic options and insufficient training of health professionals are just some of the reasons mentioned for not addressing sexual dysfunction in a general consultation.What do the results of this study add? Our study is the first research in Spain on the impact of age, menopause and QoL on gynaecological patients´ FSF. Our results indicate that an impaired FSF could be related to poorer well-being and QoL; however, benign gynaecological disease does not appear to affect FSF. Elderly age and postmenopausal state can have deleterious effects on FSF.What are the implications of these findings for clinical practice and/or further research? Sexuality is an important aspect of QoL. Therefore, gynaecologists should discuss issues of sexuality with their patients in routine visits, especially in case of elderly and postmenopausal women. In addition, gynaecologists should train in the diagnosis and treatment of the female sexual dysfunction.

The prevalence of hypoactive sexual desire disorder in Australian and Iranian women at midlife

OBJECTIVE

This study was undertaken to examine whether the prevalence of low sexual desire, sexually related personal distress, and epidemiological hypoactive sexual desire disorder (eHSDD) differed between midlife Australian and Iranian married women.

METHODS

Cross-sectional, community-based studies of women aged 40 to 65 years conducted in Australia (2013-2014, n = 2,020) and Iran (2016-2017, n = 1,520) included 60% and 89% married women, respectively. Participants completed the Female Sexual Function Index and the Female Sexual Distress Scale-Revised. eHSDD was defined as low desire with sexually related personal distress.

RESULTS

Restricting the analysis to married women, 76.5% of the 1,210 Australian women, mean age (SD) 52.4 (6.8) years, and 87.8% of the 1,348 Iranian women, mean age 48.5 (6.7) years who were recently sexually active. Low desire was more prevalent in Australian women than Iranian women (68.8%, 95% CI 66.1-71.3 vs 51.3%, 95% CI 48.6-53.9, P < 0.001) as were sexually related personal distress (47.6%, 95% CI 44.8-50.4 vs 17.2%, 95% CI 15.3-19.3, P < 0.001) and eHSDD (39.7%, 95% CI 36.9-42.5 vs 13.9%, 95% CI 12.2-15.9, P < 0.001). Being sexually inactive, versus sexually active, was associated with low desire, sexually related personal distress and eHSDD in Australian women (P < 0.001), but only with low desire in Iranian women (P < 0.001).

CONCLUSIONS

The prevalence of eHSDD in married Australian women at midlife was threefold that of Iranian women, primarily due to the higher prevalence of sexually related personal distress. The results were only adjusted for age and sexual activity, and analyses did not account for other observed differences between the study populations. Hence, future studies are warranted to explore if the differences between the two populations are due to variations in demographics such as level of education or employment and/or due to expectations, experiences, or beliefs.

Association of menopause symptoms with depressive symptom severity in a diverse community-based sample

The Dallas Heart Study dataset was used to examine relationships between menopausal symptoms and depressive symptom severity in 384 women (37-73 years old) self-reporting as menopausal. Self-reported menopausal symptoms were grouped based on the Menopause-specific Quality of Life Questionnaire (MENQOL). Depressive symptom severity was assessed using the Quick Inventory of Depressive Symptomatology - Self-Report (QIDS-SR). The relationship between menopause symptom groups, ethnicity and QIDS-SR was evaluated using multiple linear regression. Endorsement of sexual symptoms was positively associated with QIDS-SR score (β = .12, p = .031), suggesting that sexual dysfunction during menopause may be a predictor of underlying depressive symptoms.

Brain Morphological Changes With Functional Deficit Associated With Sexual Arousal in Postmenopausal Women

INTRODUCTION

We have not known how menopause synchronously influences brain morphology and function associated with visually stimulated sexual arousal in postmenopausal women.

AIM

This study used a combination of functional magnetic resonance imaging and voxel-based morphometry to evaluate menopause-related brain morphological and functional changes in postmenopausal women.

METHODS

Nineteen premenopausal women and 19 postmenopausal women underwent functional and structural magnetic resonance imaging. Brain function activity was measured while the subjects viewed an erotic video clip.

MAIN OUTCOME MEASURES

A 2-sample t-test was used for cross-analysis of the 2 groups for comparison of gray matter volumes (corrected P < .05) and brain activation (uncorrected P < .01).

RESULTS

Our study revealed a relationship between sexual function and morphological changes in postmenopausal women. Compared with premenopausal women, the postmenopausal group showed significantly lower brain activations in the major parts of the limbic system and basal ganglia, including the parahippocampal gyrus, head of caudate nucleus, insula, putamen, hippocampus, hypothalamus, amygdala, and globus pallidus, which are involved in sexual behavior and emotional responses. In morphometric analyses, postmenopausal women showed significantly decreased gray matter volumes of the insula, putamen, parahippocampal gyrus, amygdala, and anterior cingulate gyrus, most of which were associated with decreased functional activity during visual sexual arousal in postmenopausal women. In addition, the premenopausal group alone showed a positive correlation between the activity of the insula and the level of estradiol (Pearson correlation r = 0.588; P = .008).

CONCLUSION

This study demonstrates an association between menopause-related brain function and morphological changes in postmenopausal women. This finding provides insight into the neural mechanisms associated with the sexual functional deficit in postmenopausal women. Baek H-S, Kim G-W, Sundaram T, et al. Brain Morphological Changes with Functional Deficit Associated with Sexual Arousal in Postmenopausal Women. Sex Med 2019;7:480-488.

Examining sexual functions of women before and after menopause in Turkey

Background

Sexuality is an important factor that completes the lives of individuals and affects people in all age groups.

Objectives

To examine the sexual functions of women before and after menopause.

Methods

This cross-sectional study was conducted at the Family Health Centers in Tunceli Turkey,\ between September 2014 and February 2015. The study data were obtained using a Questionnaire and the Female Sexual Function Index. The data were analyzed by number, percentage distribution, mean, standard deviation, t-test, and using binary logistic regression analysis.

Results

The mean Female Sexual Function Index score of the women was 23.8±8.0. The Female Sexual Function Index score of 59.7% of women was below the cut-off score (26.55) and was accepted indicative of sexual dysfunction. Low educational level (P < 0.01), low income (P < 0.01), and menopausal status (P < 0.0001) of the women were risk factors for sexual dysfunction.

Conclusion

Prevalence of sexual dysfunction in the women was very high and they indicated no effort to seek medical care. Low educational and income level and menopausal status of the women were three factors increasing the risk of sexual dysfunction. Awareness of the society and the healthcare professionals about the issue should be increased.

Sexual Function and Factors Affecting Menopause: A Systematic Review

The purpose of this review study is to evaluate sexual function and its effective factors in menopause. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The key words of “menopause,” “postmenopause,” “postmenopausal,” “premenopause,” “pre-menopausal period,” “sexual function,” “sexual health,” “sexuality,” “sexual and gender disorders,” “sexual development,” “sexual dysfunction,” “sexual disorders,” “sexual behavior and “sexual activity” were used in combination with the Boolean operators OR and AND. After reviewing the selected articles, 27 papers were selected based on the criteria for entering the study and the goals set. The results of the reviewed articles showed that, in the physical domain, the factors affecting sexual function can be mentioned, age, hormonal changes, medical problems and reproductive history. Sexual disorders in menopause can be affected by some of the individual and social characteristics and psychological problems. Considering the fact that many psychological and social injuries occur in this period following sexual disorders; therefore, policies and programs for improving the quality of life of women in menopause should be aimed at eliminating sexual dysfunction, correcting attitudes and negative emotions and help to women for more comfortable in menopause.

Decline in sexuality and wellbeing in older adults: A population-based study

BACKGROUND

Age-related declines in sexuality and increase in mental health complications have been well documented. However, whether these two phenomena are related has not been explored. The present study therefore aimed to investigate associations between a decline in sexuality and markers of mental health and wellbeing.

METHOD

Data were collected in 2012/13 from 2614 men and 3217 women participating in the English Longitudinal Study of Ageing, a population-representative panel study of older adults (≥ 50 years). Past-year declines in sexual desire, frequency of sexual activities, and sexual function were self-reported. Three markers of wellbeing (depressive symptoms, quality of life and life satisfaction) were assessed using validated scales. Associations between declines in sexuality and wellbeing were analysed using one-way independent analyses of variance, adjusted for a range of socio-demographic and health-related covariates.

RESULTS

Men and women who reported a past-year decline in sexual desire or frequency of sexual activities had a higher number of depressive symptoms (desire p = 0.001, frequency p < 0.001) and lower quality of life (all p < 0.001). Decline in sexual desire was also associated with lower life satisfaction in men (p = 0.012) and decline in frequency of sexual activities was associated with lower life satisfaction in women (p < 0.001). Declines in erectile function in men and ability to become sexually aroused in women were also significantly associated with more depressive symptoms (p < 0.001), lower quality of life (p < 0.001) and lower life satisfaction (p < 0.001 in men, p = 0.024 in women).

CONCLUSION

Older adults who experience a decline in sexuality report poorer wellbeing than those who do not.

Effects of physical and depressive symptoms on the sexual life of Turkish women in the climacteric period

OBJECTIVE

To assess the effects of physical and depressive symptoms on the sexual life of women in the climacteric period.

METHODS

This study was conducted with 572 women at a university hospital. The Beck Depression Inventory (BDI), Menopause Rating Scale (MRS) and Female Sexual Function Index (FSFI) were used to evaluate depressive symptoms, intensity of menopausal symptoms and sexual function.

RESULTS

Sexual dysfunction and depressive symptoms were determined in 86.4% and 54.9% of the women, respectively. In univariate analysis, women without health insurance, with low income, being married for longer than 21 years and being in menopause had low FSFI but high BDI and MRS scores. In multiple regression analysis, advanced age of women, women with low income, unemployed women, low educated women and their husbands and women with depressive symptoms had low FSFI scores. There was a negative relationship between total FSFI and MRS and BDI scores.

CONCLUSION

Determination and treatment of sexual, emotional and physical problems in the climacteric period are very important for the improvement of the quality of life of women.

Sexual function and quality-of-life-related problems during the menopausal period

This study aims to evaluate the relationship between the sexual functions and quality of life and the problems during menopausal period. This descriptive, cross-sectional study included a total of 317 women. The mean total Female Sexual Function Index score was 18.8 ± 8.7, while the mean total Sexual Quality of Life Questionnaire-Female score was 72.7 ± 13.7. Sexual dysfunction was found in 82 percent. There was a positive significant correlation between the total Female Sexual Function Index scores and total Sexual Quality of Life Questionnaire-Female scores ( p < 0.05). Our study results suggest that women do not often experience serious menopausal symptoms, but have sexual dysfunction with a moderate sexual quality of life.

Depressive symptoms and their risk factors in midlife women in the Middle East: a systematic review

INTRODUCTION

Women may experience different menopausal symptoms across different cultures around the world. The purpose of this study was to determine the prevalence and contributing factors of depression in midlife women in the Middle East.

METHODS

Electronic databases including PubMed, Medline, PsycINFO, CINAHL, Web of Science, SCOPUS, and Google scholar were searched. The quality of articles was assessed by using the risk of bias tool.

RESULTS

Sixteen articles were used for this review. The prevalence for depressive symptoms in perimenopausal women is higher than in premenopausal women. The overall data also suggest that depressive symptoms may be more prevalent in postmenopausal women than in premenopausal women. Studies reported sociodemographic, physical, psychological, cultural and sexual risk factors for depressive symptoms in middle-aged women. Risk of bias for a majority of the studies conducted in the Middle Eastern region on depression in midlife was moderate.

CONCLUSION

Consistent with other areas in the world, midlife women in the Middle East region are at higher risk for depression due to the presence of different factors. High-quality longitudinal studies of representative samples, using validated questionnaires, are needed to provide more accurate prevalence data and the association between menopause and menopausal symptoms in women in the Middle East.

Factors Affecting Sexual Function in Midlife Women: Results from the Midlife Women's Health Study

OBJECTIVE

The objective of this study was to estimate the importance of risk factors affecting sexual function in sexually active midlife women.

MATERIALS AND METHODS

A cohort of 780 women undergoing the menopausal transition was surveyed each year for up to 7 years. Data were collected from sexually active women on sexual function, including frequencies of enjoyment, arousal, orgasm, passion for partner, satisfaction with partner, pain, lack of lubrication, fantasizing, and sexual activity. Data were also collected on a large number of potential risk factors for sexual dysfunction, including behaviors (smoking and alcohol use), health status (overall and frequency of different disorders), and demographic information (race, education, income, etc.). Height and weight were measured at an annual clinic visit; serum hormone concentrations were assayed using blood samples donated annually. Data on individual outcomes were examined with ordinal logistic regression models using individual as a random effect. An overall sexual function score was constructed from individual outcome responses, and this score was examined with linear regression. All factors with univariate associations of p < 0.1 were considered in multivariate model building with stepwise addition.

RESULTS

A total of 1,927 women-years were included in the analysis. Women with much more physical work than average had higher sexual function scores and higher rates of enjoyment, passion, and satisfaction. Higher family income was associated with lower sexual function score and more frequent dry sex. Married women had significantly lower sexual function scores, as did those with frequent irritability or vaginal dryness. A higher step on the Ladder of Life was associated with a higher sexual function score and higher frequency of sexual activity.

CONCLUSIONS

The factors associated with sexual outcome in menopausal women are complex and vary depending on the sexual outcome.

Factors Affecting Sexual Activity in Midlife Women: Results from the Midlife Health Study

BACKGROUND

The objective of this study was to identify (1) the importance of a number of potential factors affecting the likelihood of sexual activity in perimenopausal women and (2) the likelihood of a number of barriers to sexual activity.

METHODS

A cohort of 780 women undergoing menopausal transition was surveyed annually for up to 7 years. Data were collected on sexual activity and, if not sexually active, reasons for no sexual activity, as well as a number of potential risk factors. Height and weight were measured at an annual clinic visit; serum hormone concentrations were assayed using blood samples donated annually. Data were examined with logistic regression models using the individual as a random effect, with subset analysis of nonsexually active women to determine the likelihood of each barrier. All factors with univariate associations of p < 0.1 were considered in multivariate model building with stepwise addition.

RESULTS

A total of 2440 woman-years were included in the analysis of sexual activity. The likelihood of sexual activity increased for women living with a partner, with perceived quality of life, and with less frequent hot flashes. Among 513 woman-years reporting no sexual activity, women living with a partner and women reporting frequent fatigue were less likely to lack a sexual partner, but were more likely to have sexual difficulties. Women with more physical work than average and women with higher serum estradiol levels were less likely to have sexual difficulties.

CONCLUSIONS

The factors associated with sexual activity in menopausal women are complex, indicating that an individualized approach to improving sexual activity is required.

Men's perceptions and attitudes toward their wives experiencing menopause

In this study, we explore men's perceptions, experiences, and attitudes toward wives experiencing natural menopause. We interviewed 20 men using the oral history method. Descriptive categories of experiences, such as misconceptions about menopause overcome through coexistence and recognition of women's perspectives; recognition of women's needs and efforts to provide support; coping with changes in marital relations and need to start a new time in couple's life; and existence of several needs as husbands of women experiencing menopause were explored. A better understanding by men about the changes experienced by menopausal women fosters the development of a better emotional support for their wives, which improves the quality of marital relations.

Menopause and crisis? Fake or real: comprehensive search to the depth of crisis experienced: a mixed-method study

INTRODUCTION

Menopause is beyond the lack of menstruation and fertility decline in estrogen. Menopause is associated with at least three types of crisis: Biological, psychological and social. The aim of this study was to investigate psychiatric problems related to menopausal stress and experiences about psychological conditions related to menopause as a developmental crisis.

MATERIALS AND METHODS

This mixed-method study (by triangulation approach) was done on 300 women in menopause age (44-54 years) by consensus sampling. Data gathering was from questionnaire conclude psychosomatic listed and hypochondria's criterion that has been specified by DSMIV. The severity of the disorder was also collected by self-reported question. In the qualitative part, as a phenomenology study, data were gathered with Purposive sampling by a deep semi-structured interview. Data analysis was from content analysis).

RESULTS

Results showed that most of the disorders from psychosomatic listed experienced by women conclude: sexual problems 101(33.7%), hypertension 39(13%), and constipation 30(10%); 2.9% had experienced hypochondrias disorder. In the qualitative part, 5 themes were driven from the results of this study which described the structures of psychological experiences of the menopause as follows: change in emotion and mood, change in attitude, change in self-concept and change in interpersonal relationships.

CONCLUSION

Menopause is a physiological process in women's life, but due to many symptoms and complications, it requires culturally appropriate education, appropriate coping with problems and mental health promotion in this sexual crisis.

A Turkish study on menarche and menstrual experiences and their effects on attitudes towards menopause

The purpose of this study was to investigate women's menarche and menstrual experiences and their effects on attitudes towards menopause. This research was planned as cross-sectional. A total of 300 women who had applied for a physical examination at the Maternity and Gynecology and Children's Hospital of Ordu province of Turkey were recruited for the study using the convenience sampling method. The study was conducted between 16 April and 28 May 2008. The research data were gathered using the Menopause Attitude Scale and a questionnaire. The average score for women on the Menopause Attitude Scale was 37.85 ± 10.34. Significant differences were found between attitudes of women towards menopause and the information they had received before menarche about menstruation (P = 0.024), the meaning of menstruation (P = 0.014), the interval time between menstrual periods (P = 0.017), problems experienced before menstruation (P = 0.035) and the desire of some women to continue menstruating and delay menopause (P = 0.005). Results of this study showed that more than half of the women had negative attitudes towards menopause. In order to help girls and women develop positive attitudes about menarche, menstruation and menopause, they need to have access to information during all phases of these important physical changes.

Analysis of two polymorphisms of the manganese superoxide dismutase gene (Ile-58Thr and Ala-9Val) in patients with recurrent depressive disorder

Reactive oxygen species (ROS) may contribute to the pathogenesis of depressive disorder (DD). Functional genetic polymorphisms of manganese superoxide dismutase (MnSOD) are candidates for DD susceptibility. The study examined the relationship between MnSOD gene polymorphisms (Ala-9Val, Ile-58Thr) and DD in the Polish population. The association study was conducted in a case-control design in DD patients (n=149) and healthy controls (CG; n=149) by genotyping. Assessment of Ala-9Val genotype distribution and disease odds ratio demonstrated a statistically significant difference between the compared groups only in the female subgroup. The obtained results suggest a role of the MnSOD polymorphism in the development and course of depression.