Serum Estrogens and Depression in the Transition to Menopause- Systematic Review

Objective: To establish the relationship between the reduction of serum estrogens and depression in women in the transition towards menopause and to analyze the influence of menopausal hormone therapy. Material and Methods: A systematic review of the literature in different electronic databases (Embase, Lilacs, among others) was made, through free and standardized search terms. Outcomes assessed included transition to menopause, depression, serum estradiol (E2), follicle stimulating hormone (FSH), and menopausal hormone therapy (THM). Results: 73 publications were included. It was found that there is an association of depression with climacteric, and it was observed that the appearance of depression increases during the transition phase towards menopause. A significant negative association between circulating levels of E2 and intensity of depression was explored, as the severity of depression decreased with higher estradiol levels. In FSH levels, the opposite outcome was observed, as high FSH levels were positively related to the severity of depression. THM is an effective treatment for depression in women transitioning to menopause. Conclusions: Low serum levels of E2 and elevated levels of FSH are positively associated with the onset and severity of depression. Doctors should establish guidelines for screening for depression in women during the transition to menopause.