19 - Psychiatric disorders of menses, pregnancy, postpartum and menopause

Summary

This chapter describes the psychiatric disorders of menses, pregnancy, postpartum and menopause in women. An understanding of hormonal influences on mood is important in trying to tie together those women who appear to be an increased risk of depression premenstrually, postnatally and at menopause. Maternal anxiety and depression in pregnancy may have particular effects on the foetus. A woman suffering from premenstual dysphoric disorder (PMDD) must experience at least five premenstrual symptoms and functional impairment due to the symptoms. Women in the Western world are living longer and are consequently spending more of their lives postmenopause. Oestrogen therapy has also been used in the management of psychological/ psychiatric and cognitive symptoms associated with the menopause. However, it has been argued that these symptoms may be more related to comorbid physical and psychosocial factors rather than the effects of ovarian failure.