更年期女性にみられる精神神経症状

Declining estrogen level associated with ovarian failure has wide-ranging and unwelcome consequences and leads to diverse metabolic changes and symptoms. The short-term effects are vasomotor instability and psychological symptoms, and medium-term effects include urogenital atrophy. On the other hand, long-term consequences are an increased risk of coronary artery disease, osteoporosis and possibly Alzheimer's disease. The hormonal change occurring around menopause and their influence may be enough to trigger emotional reactions such as depression. Furthermore, life events, personality also affect psychological symptoms which include forgetfulness, fatigue, irritability, loss of concentration, depressed mood, anxiety and sleep-related problems. Middle age is considered to be a period of increased role change and occurrence of stressful life events, particularly those called exit events. Such events include children moving out, elderly parents developing illnesses and requiring assistance or dying, partners or close friends aging or developing disease, separation and divorce. Hormone replacement therapy (HRT) improves mood and increases a sense of well-being in postmenopausal women, however estrogen was not effective in women with more severe depressive symptoms. When HRT is not advisable, other treatments such as Kampo medicine, anti-anxiety drugs and counseling should be considered. It is important for postmenopausal women suffered from psychological symptoms to look for signs of increased vulnerability to hormonal fluctuation and individualize treatment.