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Nature Neuroscience Sep 2023Fluctuations in reproductive hormone levels are associated with mood disruptions in women, such as in postpartum and perimenopausal depression. However, the neural...
Fluctuations in reproductive hormone levels are associated with mood disruptions in women, such as in postpartum and perimenopausal depression. However, the neural circuit mechanisms remain unclear. Here we report that medial preoptic area (MPOA) GABAergic neurons mediate multifaceted depressive-like behaviors in female mice after ovarian hormone withdrawal (HW), which can be attributed to downregulation of activity in Esr1 (estrogen receptor-1)-expressing GABAergic neurons. Enhancing activity of these neurons ameliorates depressive-like behaviors in HW-treated mice, whereas reducing their activity results in expression of these behaviors. Two separate subpopulations mediate different symptoms: a subpopulation projecting to the ventral tegmental area (VTA) mediates anhedonia and another projecting to the periaqueductal gray mediates immobility. These projections enhance activity of dopaminergic neurons in the VTA and serotonergic neurons in the dorsal raphe, respectively, with increased release of dopamine and serotonin, possibly through disinhibition mechanisms. Thus, the MPOA is a hub that mediates depressive-like behaviors resulting from transitions in reproductive hormone levels.
Topics: Mice; Female; Animals; Preoptic Area; Ventral Tegmental Area; Dopaminergic Neurons; GABAergic Neurons
PubMed: 37524978
DOI: 10.1038/s41593-023-01397-2 -
Autoimmunity Reviews Aug 2023Menopause, defined as the permanent cessation of ovarian function, represents a period of significant fluctuation in sex hormone concentrations. Sex hormones including... (Review)
Review
Menopause, defined as the permanent cessation of ovarian function, represents a period of significant fluctuation in sex hormone concentrations. Sex hormones including oestrogen, progesterone, testosterone and anti-Mullerian hormone are thought have neuroinflammatory effects and are implicated in both neuroprotection and neurodegeneration. Sex hormones have a role in modifying clinical trajectory in multiple sclerosis (MS) throughout the lifespan. MS predominantly effects women and is typically diagnosed early in a woman's reproductive life. Most women with MS will undergo menopause. Despite this, the effect of menopause on MS disease course remains unclear. This review examines the relationship between sex hormones and MS disease activity and clinical course, particularly around the time of menopause. It will consider the role of interventions such as exogenous hormone replacement therapy in modulating clinical outcomes in this period. Understanding the impact of menopause on multiple sclerosis is fundamental for delivering optimal care to women with MS as they age and will inform treatment decisions with the aim of minimising relapses, disease accrual and improving quality of life.
Topics: Female; Humans; Multiple Sclerosis; Quality of Life; Menopause; Gonadal Steroid Hormones; Estrogens
PubMed: 37230311
DOI: 10.1016/j.autrev.2023.103363 -
BJPsych Bulletin Nov 2023Hormonal fluctuations in the perimenopause are associated with an array of physical and psychological symptoms. Those with pre-existing mental disorders may experience... (Review)
Review
Hormonal fluctuations in the perimenopause are associated with an array of physical and psychological symptoms. Those with pre-existing mental disorders may experience changes to their symptoms and response to treatment during the perimenopausal and postmenopausal periods and may also be at risk of poorer longer-term physical health outcomes in menopause. The transition towards menopause may be compounded by the oestradiol-suppressing effect of many psychotropics on the hypothalamopituitary-gonadal axis. A collaborative approach between primary care and secondary mental health services is an opportunity for proactive discussion of symptoms and support with management of the perimenopause. This may involve lifestyle measures and/or hormone replacement therapy, which can both lead to improvements in well-being and mental and physical health.
PubMed: 37955045
DOI: 10.1192/bjb.2023.89 -
Open Life Sciences 2023With the development and progress of society, people's average life expectancy has increased, and relevant literature reports that the number of postmenopausal women in... (Review)
Review
With the development and progress of society, people's average life expectancy has increased, and relevant literature reports that the number of postmenopausal women in China continues to increase. With lifespans extended, the transition period and post-menopause period have become the longest essential period in every woman's life. The life quality of women troubled by perimenopausal syndrome has been significantly reduced, which also places a burden on families and society. It is well known that hormone replacement therapy plays a vital role in improving women's menopause-related symptoms and is the most effective medical measure. With research ongoing into the treatment of menopausal symptoms in different patients, dose size, treatment duration, and medication regimens for hormones are still hot topics of discussion. This article reviews the definition, clinical diagnosis, staging, clinical manifestations, and treatment of menopause and explores the current diagnosis and treatment scenarios of perimenopausal syndrome.
PubMed: 38152579
DOI: 10.1515/biol-2022-0754 -
Australian Prescriber Oct 2023During perimenopause and after menopause, women may experience diverse symptoms. All women require a comprehensive assessment of their current health and risks for... (Review)
Review
During perimenopause and after menopause, women may experience diverse symptoms. All women require a comprehensive assessment of their current health and risks for future disease, appropriate screening, and promotion of a healthy lifestyle. Menopausal hormone therapy is the most effective treatment for menopausal symptoms. It can be offered to symptomatic patients with no contraindications following an individualised discussion about the risk of harms versus benefits. Menopausal hormone therapy is recommended for women with premature ovarian insufficiency (menopause occurring before 40 years of age) regardless of symptoms, unless contraindicated. Nonhormonal medications may improve symptoms for women who have contraindications to, or do not wish to take, menopausal hormone therapy.
PubMed: 38053812
DOI: 10.18773/austprescr.2023.014