As the number of women who are experiencing menopause triples, the demand for more effective treatment of symptoms such as mood changes is also expected to increase. To address this situation, a psychiatrist at the School of Medicine has launched a major series of studies on mood disorders and menopausal women that may offer relief from some symptoms.
Dr. Angela Cappiello, chief of the Menopause Mood Disorders Clinic and codirector of the Behavioral Gynecology Program at the School of Medicine, is studying whether estrogen replacement helps women who are severely depressed and whether a low-tryptophan diet affects menopausal women.
Estrogen loss may increase stress. "My goal is to understand the connection between the mind and the female hormone, estrogen," says Dr. Cappiello, whose study is funded by the Lilly Center for Women's Health. "Female hormones may protect women from stress. Loss of estrogen could cause women to be more vulnerable to stressful life changes that usually occur around the time of menopause, including changes in employment, marriage and children leaving home."
An estimated 30 million women are expected to reach menopause in the next 10 years, and more than one-third of a woman's life is post-menopausal, Dr. Cappiello points out. Previous research has shown that estrogen regulates brain activity and that loss of estrogen can impact mood and behavior. Approximately 85 percent of women have some kind of reaction to estrogen loss and 15 percent of them have more severe symptoms.
Low-tryptophan diet. Dr. Cappiello's research will focus on women who fall into three categories: healthy menopausal women, women who are clinically depressed, and menopausal women who are no longer depressed but are currently taking anti-depressants. Women who are not clinically depressed will be put on a low-tryptophan diet and estrogen. Tryptophan is an amino acid that is a precursor of serotonin. Research involving animals has shown that if they are deprived of serotonin, animals may adapt more poorly to adverse situations. The same is true in humans, according to Dr. Cappiello. Tryptophan is found mostly in dairy foods and poultry; foods low in tryptophan include fruits and vegetables such as apples, lettuce and tomatoes.
Dr. Cappiello will also conduct a treatment study of menopausal women who are clinically depressed and will evaluate the vulnerability to depression in women who are currently taking antidepressants.
Treatment available. The psychiatrist would like her study to make women aware that they do not have to suffer in silence with menopausal symptoms such as mood changes, depression, hot flashes and insomnia. "We want to let women know that treatment is available for many of these symptoms," says Dr. Cappiello.
The Menopause and Mood Disorders Clinic is part of the Yale Behavioral Gynecology Program operated jointly by the departments of psychiatry and of obstetrics and gynecology at the School of Medicine. The clinic, which is located at the West Haven campus of the VA Connecticut Healthcare System, offers comprehensive evaluation and anti-depressant treatment for menopausal women.
Women who are interested in participating in Dr. Cappiello's study should call 937-4862.