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Melatonin in perimenopausal and postmenopausal women: associations with mood, sleep, climacteric symptoms, and quality of life

Toffol, Elena MD1,2; Kalleinen, Nea MD, PhD3,4; Haukka, Jari PhD1,5; Vakkuri, Olli PhD6; Partonen, Timo MD, PhD1; Polo-Kantola, Päivi MD, PhD3,7

doi: 10.1097/GME.0b013e3182a6c8f3
Original Articles

Objective: Melatonin synthesis and secretion are partly modulated by estrogen and progesterone. Changes in melatonin concentrations, possibly related to the menopausal transition, may be associated with climacteric mood, sleep, and vasomotor symptoms. The aims of this study were to compare the serum concentrations of melatonin in perimenopausal and postmenopausal women and to evaluate melatonin’s influence on mood, sleep, vasomotor symptoms, and quality of life.

Methods: We analyzed the data of 17 healthy perimenopausal women (aged 43-51 y) and 18 healthy postmenopausal women (aged 58-71 y) who participated in a prospective study. On study night (9:00 pm-9:00 am), serum melatonin was sampled at 20-minute (9:00 pm-12:00 midnight; 6:00-9:00 am) and 1-hour (12:00 midnight-6:00 am) intervals. Questionnaires were used to assess depression (Beck Depression Inventory), anxiety (State-Trait Anxiety Inventory), insomnia and sleepiness (Basic Nordic Sleep Questionnaire [BNSQ]), subjective sleep quality, vasomotor symptoms, and quality of life (EuroQoL).

Results: Postmenopausal women had lower nighttime serum melatonin concentrations than perimenopausal women. The duration of melatonin secretion tended to be shorter in postmenopause, whereas melatonin peak time did not differ. Mean melatonin concentrations and exposure levels did not correlate with follicle-stimulating hormone level, estradiol level, body mass index, Beck Depression Inventory score, State-Trait Anxiety Inventory score, BNSQ insomnia score, BNSQ sleepiness score, subjective sleep score, climacteric vasomotor score, or quality of life. In perimenopause, the later is the melatonin peak, the higher is the level of anxiety (P = 0.022), and the longer is the melatonin secretion, the better is the quality of life (P < 0.001).

Conclusions: Longitudinal research is needed to better understand the possible contributory role of menopause in lower melatonin levels.

From the 1Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare THL, Helsinki, Finland; 2Department of Psychiatry, University of Helsinki, Helsinki, Finland; 3Sleep Research Unit, Department of Physiology, University of Turku, Turku, Finland; 4Heart Center, Turku University Hospital, and University of Turku, Turku, Finland; 5Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland; 6Institute of Biomedicine, University of Oulu, Oulu, Finland; and 7Department of Obstetrics and Gynecology, Turku University Hospital, and University of Turku, Turku, Finland.

Received May 15, 2013; revised and accepted July 18, 2013.

Funding/support: This study was financially supported by a European Commission grant (QLK6-CT-2000-00499), the Väinö and Laina Kivi Foundation, The Finnish Menopause Society Foundation, The Finnish Medical Foundation, and The Turku University Foundation (P.P.-K.). Further financial support was provided through grants from the Research Foundation of the University of Helsinki, the Center for International Mobility, the Lundbeck Foundation, and the National Graduate School of Clinical Investigation (Helsinki, Finland; to E.T.).

Financial disclosure/conflicts of interest: None reported.

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Address correspondence to: Elena Toffol, MD, Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare THL, PO Box 30, Mannerheimintie 170, Helsinki FI-00271, Finland. E-mail:

© 2014 by The North American Menopause Society.