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Disruptions in ovarian function are related to depression and cardiometabolic risk during premenopause

Bleil, Maria E. PhD1; Bromberger, Joyce T. PhD2; Latham, Melissa D. BA1; Adler, Nancy E. PhD1; Pasch, Lauri A. PhD1; Gregorich, Steven E. PhD3; Rosen, Mitchell P. MD4; Cedars, Marcelle I. MD4

doi: 10.1097/GME.0b013e31827c5c45
Original Articles
Editorial

Objective: The aim of this study was to evaluate the extent to which mild disruptions in ovarian function, indexed by changes in menstrual cycle length, may relate to cardiometabolic and psychological health in premenopausal women.

Methods: Among 804 healthy, regularly cycling women (aged 25-45 y; mean [SD] age, 35.5 [5.5] y), patterns of any change (shortening, lengthening, or increased variability) versus no change in menstrual cycle length were examined in relation to a composite of cardiometabolic risk and individual risk factors (high-density lipoprotein, triglycerides, waist circumference, glucose, and hypertensive status), as well as in relation to depression indicators (Center for Epidemiological Studies Depression Scale score ≥16 [yes/no], lifetime depression diagnosis [yes/no], and lifetime antidepressant medication use [yes/no]). Models were also explored to test whether changes in menstrual cycle length mediated relations between depression history and cardiometabolic risk.

Results: In covariate-adjusted models compared with no change, any change in menstrual cycle length was associated with higher cardiometabolic risk composite scores and lower high-density lipoprotein (P < 0.05). In addition, compared with no change, any change in menstrual cycle length was associated with a Center for Epidemiological Studies Depression Scale score of 16 or higher, having received a depression diagnosis, and having used antidepressant medications (P < 0.05). In exploratory analyses, any change in menstrual cycle length partially mediated the relation between depression history and cardiometabolic risk (b = 0.152, P = 0.040), which attenuated (b = 0.129, P = 0.083) when any change in menstrual cycle length was covaried.

Conclusions: Findings suggest that disruptions in ovarian function, marked by subtle changes in menstrual cycle length, may relate to aspects of cardiometabolic and psychological health among healthy, premenopausal women.

From the 1Department of Psychiatry, University of California San Francisco, San Francisco, CA; 2Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA; and Departments of 3Medicine and 4Obstetrics, Gynecology,and Reproductive Sciences, University of California San Francisco, SanFrancisco, CA.

Received July 24, 2012; revised and accepted November 2, 2012.

Funding/support: Preparation of this manuscript and the research described here were supported by the National Institutes of Health (NIH)/National Institute of Child Health and Human Development and NIH/National Institute on Aging (R01 HD044876), NIH/National Institute on Aging (K08 AG03575), NIH/University of California San Francisco Clinical and Translational Science Institute (UL1 RR024131), the Brain and Behavior Research Foundation, and the Robert Wood Johnson Foundation (045820).

Financial disclosure/conflicts of interest: None reported.

Address correspondence to: Maria E. Bleil, PhD, University of California San Francisco, Suite 465, 3333 California Street, San Francisco, CA 94143-0848. E-mail: maria.bleil@ucsf.edu

© 2013 by The North American Menopause Society.