Menopausal transition, mood, and cognition: an integrated view to close the gaps

Epidemiological and clinic data support the notion that some women may be at higher risk for developing mood and anxiety symptoms and cognitive complaints during certain periods in life that are marked by intense hormone variations and psychosocial stressors. The complexity of the so-called windows of vulnerability poses a particular challenge to professionals involved in the care of female patients. Menopausal transition is perhaps a paramount example; the process itself is marked by progressive, dynamic changes in hormone levels and reproductive function that interact with the aging process, changes in metabolism, sexuality, lifestyle behaviors, and overall health. The putative compounded burden of health challenges associated with this transition has become a main focus of attention of physicians and researchers who aim to identify preventive and/or early intervention strategies to promote healthy aging in midlife women. Recent studies have provided further evidence that the menopausal transition may be not only a window of vulnerability for depression and cognitive impairment but also a critical "window of opportunity" for the success of hormone-based treatments. The need for further investigation and better understanding of common underlying mechanisms seems intuitive. An ultimate goal could include preventive strategies for women presenting with various risk factors for cardiovascular, cognitive, and mood disorders as well as treatments that could be tailored to multiple symptom domains during the menopausal transition.