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Trial to treat depression in perimenopausal women

Research 11 Nov 2020
Perimenopausal woman depression

Melbourne researchers are trialling a new drug mix which they hope may lower anxiety and lift the mood of perimenopausal women.

Researchers in Melbourne have launched a study to see if an experimental mix of medicines can successfully treat depression in women experiencing perimenopause.

Ninety women will take part in the new study which will be led by Professor Jayashri Kulkarni AM and her team at the Alfred Monash Psychiatry (AMP) Research Centre.

Perimenopause is the time in a woman’s reproductive life before menopause. Most women reach menopause between the ages of 45 and 55, but the years leading up to menopause can cause symptoms similar to, or even more intense, than menopause. This is due to hormone fluctuations as the ovaries begin to slow down and run out of eggs.

Due to these hormonal changes, the risk of serious depression is increased in perimenopausal women. Symptoms can include low energy, irritability, paranoid thinking and reduced self-esteem. Many women are treated with standard antidepressants, but often show only little or no improvement.

Various women illustration

There has been little research around the mental health of perimenopausal women. Apart from the toll on women and their families, the economic cost of depression and anxiety in women (from lost productivity) is estimated by the Australian Bureau of Statistics to be as high as $22 billion each year.

In Prof Kulkarni’s study, half of the women will be given a combination of bazedoxifene – a tissue-selective oestrogen compound – and a conjugated oestrogen – a mixture of oestrogen hormones – while the other half will be given a placebo.

“This medication is to target the changes to the reproductive hormones, which we think will be a better overall treatment,” explains Dr Natalie Thomas, a research fellow at the AMP Research Centre.

“There is a lot of pre-clinical and clinical work to suggest that oestrogen helps to lift mood. The reason we want to trial this particular drug is that it is tissue selective. It will target the brain.”

Dr Natalie Thomas

Dr Thomas says the researchers have already completed a trial with tibolone, a synthetic steroid with a mixed hormonal profile which showed good results in treating perimenopausal depression. “It breaks down into oestrogen and we are seeing good results in this group of women,” she says.

“The reason we want to try this new medication mix is that it works a little differently. Bazedoxifene is tissue selective – it works in the brain and the bone. It is currently prescribed as Duavive for women in menopausal transition experiencing physical symptoms like hot flushes.

“It is approved by the TGA (the Australian Therapeutic Goods Administration) to treat moderate to severe vasomotor symptoms associated with menopause.

“We are investigating the drug for mental health purposes.”

Dr Thomas says the researchers hope the study will be able to establish if the drug can lift the mood and lower the anxiety levels of affected women.

They will use a detailed questionnaire called the MENO-D to track the severity of the illness and to monitor improvements. The women will be tracked for three months.

For more information on the trial, email maprc@monash.edu or call (03) 9076 6567.

For more information on perimenopause, please visit our 'Understanding perimenopause - fact sheet' resource page.