Document Type : Review Article


1 Department of Biochemistry, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran

2 Department of Laboratory Sciences, School of Paramedical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran

3 Department of Physical Education and Sport Sciences, Science and Research Branch, Islamic Azad University of Ayatollah Amoli, Amol, IR Iran


Context: Menopause is characterized by amenorrhea and increase in the level of Follicular Stimulating Hormone (FSH) due to the permanent cessation of ovarian function. This process causes changes in hormonal and other serum markers. Depression is the leading cause of disease-related disabilities in women.
Objectives: The aim of this review was to investigate the correlation between hormonal and petrochemical changes and depression with menopausal status.
Data Sources: We searched in Cochrane Library, MEDLINE, PubMed, Google Scholar, Web of Science and Scopus, Embase, the reference lists of all related studies and major relevant review articles from 1960 to October 2014, and also abstracts from associated congresses and meetings, using terms related to hormonal and serum markers, depression and its symptoms.
Study Selection: The survey included prospective, retrospective and case-control studies. The selected studies explored menopause in study population and investigated variables and different markers in depression or anxiety, as well as those measuring depression or anxiety intensity.
Data Extraction: Items for which data were extracted included the date and place of publication, study design, sources, human species, age, control groups, selection and appraisal methods, outcome measurement tools, and author’s conclusions. One investigator (Mostafa Chashmposh) collected the relevant reports, whereas two other authors independently reviewed the published data and reported different hormonal markers related to depression as evaluated by different studies. Disagreements were resolved by the fourth reviewer’s decision.
Results: The period of menopause is mostly associated with a gradual decline of estrogen activity and increased secretion of nocturnal melatonin. During menopausal transition, overnight cortisol levels were associated with changes in estrone glucuronide, testosterone, and FSH levels. In addition, whole blood serotonin concentration is reduced during menopause. Furthermore, lipid markers including total and LDL cholesterol levels increase during perimenopause. Moreover, plasma Brain Derived Neurotropic Factor (BDNF) concentration decreases significantly in postmenopausal period. Based on different studies, the reduction of hormones including estrogen, serotonin and BDNF during menopause are associated with depression in women. Further studies documented the relationship between depressed mood symptoms and cortisol levels.
Conclusions: The available evidence suggests that transition to menopause and its changing hormonal and other serum markers are strongly associated with depressed mood among women.