Hormonal substitution during menopause: what are we treating?

Objectives: It is suggested that during menopausal transition, women with v asomotor symptoms benefit from HRT, (hormone replacement therapy) whereas, the use of HRT for other cognitive-vegetative symptoms is questionable. Met hods: The occurence of menopausal complaints and depressive symptoms was as sessed cross-sectionally in 5896 Dutch Caucasian women (47-54 years) of a l arge community sample in the city of Eindhoven, The Netherlands. Menopausal complaints were assessed using a 22 items self-rating scale (consisting of a vasomotor, uro-genital and a cognitive-vegetative subscale). Depressive symptoms were assessed using the Edinburgh depression scale (EDS). Differen ces in mean scores were analysed between groups using ANOVA. The independen t relationship of depressive symptoms to the intensity of menopausal compla ints was assessed, by multiple linear regression analysis. Results: Women u sing HRT showed the highest scores on all subscales. Oral contraceptive use rs had significantly lower scores on the vasomotor subscale compared to HRT users and to non users. Depressive symptoms contributed the most, to the e xplained Variance on scores on the menopausal subscales. Conclusions: Women during menopause presenting several complaints, other than vasomotor origi n might be suffering from underlying depression which makes it questionable to prescribe HRT for the latter symptoms. (C) 2000 Elsevier Science Irelan d Ltd. All rights reserved.