The bidirectional relationship between vasomotor symptoms and depression across the menopausal transition: a systematic review of longitudinal studies

Natari, Rifani B., Clavarino, Alexandra M. , McGuire, Treasure M. , Dingle, Kaeleen D. and Hollingworth, Samantha A. (2017) The bidirectional relationship between vasomotor symptoms and depression across the menopausal transition: a systematic review of longitudinal studies. Menopause, 25 1: 109-120. doi:10.1097/GME.0000000000000949


Author Natari, Rifani B.
Clavarino, Alexandra M.
McGuire, Treasure M.
Dingle, Kaeleen D.
Hollingworth, Samantha A.
Title The bidirectional relationship between vasomotor symptoms and depression across the menopausal transition: a systematic review of longitudinal studies
Journal name Menopause   Check publisher's open access policy
ISSN 1530-0374
1072-3714
Publication date 2017-07-01
Sub-type Article (original research)
DOI 10.1097/GME.0000000000000949
Open Access Status Not yet assessed
Volume 25
Issue 1
Start page 109
End page 120
Total pages 12
Place of publication Philadelphia, PA, United States
Publisher Lippincott Williams & Wilkins
Language eng
Subject 2729 Obstetrics and Gynaecology
Abstract Objective: To explore the nature of the bidirectional relationship between vasomotor symptoms (VMS) and depression, and to determine whether hot flashes and night sweats differentially affect the association between VMS and depression through their effect on sleep disruption. Methods: Multiple databases were searched from 1961 until July 31, 2016, and a manual search of reference lists of identified articles was conducted. Sixteen articles that involved 10,008 participants were identified and analyzed. Results: The methods of analyses and measurement of VMS and depression varied across the studies. Two studies explored the bidirectional association, but only one was significant in both directions (odds ratio [OR] depression to VMS 3.06, 95% confidence interval [CI] 1.43-6.58; OR VMS to depression 8.88, 95% CI 2.57-30.68). In both cases, the association between VMS leading to depressive symptoms was stronger than the opposite. Eleven studies examined VMS leading to depression, but only five showed a significant effect (OR 1.57-1.81, P≤0.02). Treating VMS and depressive symptoms as continuous variables (n=3) diminished the relationship. Three studies showed a significant association of depression leading to VMS (OR 1.62-1.94, P≤0.01). We found little evidence for a specific effect of night sweats on the association between VMS and depressive symptoms. The effect might not be related to sleep disruption. Conclusions: There is a bidirectional association between VMS and depressive symptoms. The menopausal transition appears to increase the risk of recurrent episodes of depression that might not be explained only by VMS. Further investigation is needed to explain the differential effect of night sweats and hot flashes on depression.
Keyword Depression
Longitudinal observation
Menopause
Systematic review
Vasomotor symptoms
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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