It is estimated that over twenty per cent of wmoen in their forties and fifties in the US are being prescribed antidepressant drugs. Possibly a small consolation for these women is a recent study that says, "initiating pharmacological therapy always requires careful balance of potential risks and benefits of the treatment, results suggest that SSRIs and tricyclic antidepressants do not appear to have adverse effects on BMD in women".
One somewhat dubious justification for prescribing antidepressant drugs in menopausal women is that limited studies (with conflicting outcomes) show serotonin receptors present in the cells responsible for bone metabolism. However, even if this observation is confirmed it does not mean that serotonin-based, or other antidepressant drugs will promote bone growth, infact the oposite effect is equally possible.
According to researchers in the Journal of Clinical Endocrinology and Metabolism antidepressants have no effect on bone loss, so that is at least good news for at least 20% of women in the US in their forties and fifties. But it raises the obvious question - why are they on antidepressants anyway when oestrogen is the preferred frontline treatment? Depression has previously been shown to have an affect on bone loss and increased risk of fracture, but this does not mean that prescribing antidepressants is the solution. The underlying cause of bone loss, depression and other symptoms of menopause is falling oestrogen levels. Low bone density is more common in women with depression, the underlying cause of the depression is reduced oestrogen and this is the reason why it is important to treat women with transdermal oestrogen and not antidepressants and / or other bone drugs,
This subject is already covered by the PROFOX article by Professor Studd. In this article John Studd describes the nightmare scenario of treating women with a combination of antidepressants (Prozac) and Fosamax (Bisphosphonates).
Treating Symptoms of Menopause Professionally and without antidepressant drugs:
- Oestrogen therapy will replace collagen and improve the quality of skin thickness and skin elasticity.
- Oestrogen replaces the missing collagen in the matrix of osteopenic bone.
- This same anabolic effect upon the collagen protects the intervertebral discs in the spine.
- Oestrogens protect the intervertebral discs in the spine. Bisphosphonates do not.
- Oestorgen is the most beneficial treatment for low bone density.
- Osteoporosis caused by menopause should be treated by gynaecologists, not bone physicians who are untrained in endocrinology.
- All the latest information indicates that HRT is safe and is associated with the removal of most of the climacteric symptoms including loss of libido and depression as well as the more obvious hot flushes and sweats.
- It is safer to use transdermal oestrogens
- Following hysterectomy women can have oestrogens probably with the addition of testosterone without progestogen and data now from two large studies confirm that this is safe.
- There is no reason to deny women particularly under the age of 50 years relief of symptoms and protection of osteoporosis by not treating with transdermal oestrogen.
The time of a woman’s life when her ovaries stop releasing an egg (ovum) on a monthly cycle, and her periods ceaseFull medical glossary