As I was taking a psychosocial medical history of a 43-year-old woman, I asked, “What is your problem?”
“I can’t sleep at night, I can’t seem to remember anything, my muscles hurt, and I feel as if I could cry any minute,” she replied.
Sandi SquicqueroMy first thought was that this woman was going through a depressive episode. In probing further, she also had symptoms of breast tenderness and hot flashes. In further assessment, she had no life-altering experiences that indicated external causation. When asked when she last had seen her physician of record, she replied, “last year for a physical.” She was not on any medication, she took vitamins every day and exercised twice a week at a health club.
Convinced that her depression was due to menopause, I referred her back to her primary provider and encouraged psychotherapy weekly.
Menopause is a natural biological process. It occurs between the age of 30 and 55 years, with the average of onset 51 years. Every woman experiences menopause differently. Some women breeze right through menopause, and others experience a number of physical and emotional changes. Menopause is divided into two stages: perimenopause, a process leading up to menopause in which hormone levels rise and fall; and postmenopause, once a woman has not had a period in 12 months and the ovaries no longer produce estrogen or progesterone or release eggs. Although menopause is a natural occurrence, certain medical treatments can bring it on sooner, such as hysterectomy, chemotherapy and radiation treatments.
It is reported around 70% of women experience a depressive disorder as they transition into menopause. One theory states that the stress of menopausal symptoms lead to depression, yet another theory links menopausal depression with fluctuating levels of hormones. Anxiety or depression is more common in perimenopause and cause problems with sleep problems and brain fog.
Treatments of choice include estrogen therapy (to include bio-identical hormones) and antidepressants.
In speaking to a prior colleague, Dr. Frank Setzler, board certified in obstetrics and gynecology, surgery and holistic medicine, he states that 40% to 50% of his patients are on bio-identical hormones. Bio-identical (natural hormone) replacement therapy has been proposed by some doctors as a reasonable alternative to synthetic hormones. The hormones are derived from plants rather than synthetic chemicals. They require a physician prescription for the hormones estrogen, progesterone, DHEA and testosterone. Dr. Setzler, a national and international lecturer on the subject states that menopause is not about estrogen deficiency, it is more about hormone imbalance. He further states that menopause is not about hot flashes, it’s about sleep disturbance, short term memory loss and depression. “I don’t prescribe antidepressants as most of the time they are not necessary. With bio-identical hormones, I see a result in two or three weeks. Another good thing is that we measure hormone levels in saliva and can change prescriptions as patients require.”
Are you sad for prolonged periods of time? Do you feel you are experiencing perimenopausal or post menopausal symptoms that interfere with the quality of your life? Contact your primary care provider or OB-GYN and discuss a treatment plan as you may be experiencing menopausal depression which mimic the signs of depression which can be intensified by physical symptoms like hot flashes and night sweats. Menopause is not hopeless, and there are many treatments and lifestyle changes that can help manage symptoms. Psychotherapy can help you work through challenges related to menopause and teach you to manage physical and emotional symptoms.
Sandi Y. Squicquero M.Ed, LPC, is a licensed professional counselor who works out of the Medical Hypnosis and Counseling Center at 1180 Main St., Suite 5B, in Windsor. She has more than 30 years experience as a counselor and is board-certified in medical hypnosis.
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