Am I going crazy or is it menopause?


Interview with Chrisandra Shufelt, M.D.
Assistant Director of the Women’s Heart Center
at the Cedars-Sinai Heart Institute.

Dr. Shufelt is a certified menopause practitioner and a women’s health expert.

Dear Dr. Shufelt:  I stopped having my period three months ago and I didn’t miss a beat.  No crankiness, no hot flashes.  But now, my youngest is heading to college this fall and I can’t stop crying.  Is this menopause or am I going crazy?

Most women do not experience depression during menopause, but I always screen my patients for it.  Recent studies have shown that if you experienced depression at some prior point in your life, you are five times more likely to have a depression during menopause.  Depression also is more likely if you have severe hot flashes or night sweats.  Please see a healthcare provider  if you have a depressed mood for more than two weeks that is marked by the following symptoms: Overwhelming sadness, inactivity, difficulty with thinking and concentration, a significant increase or decrease in appetite and time spent sleeping, feelings of dejection and hopelessness, or suicidal thoughts.

Don’t leave depression untreated, hoping you’ll “snap out of it.”  We are finding more and more evidence that depression is a risk factor for coronary heart disease, the leading cause of death among U.S. women.

Another recent finding of interest is that Vitamin D – the sunshine vitamin – doesn’t just keep your bones healthy and strong.  Studies are finding that Vitamin D deficiencies are implicated in depression, heart disease and cancer.

Your healthcare provider can check your blood level to see if you are running low. If you are, you may need a prescription form of vitamin D just to get you back up to normal level.  How much Vitamin D do you need daily?  The Recommended Daily Allowance is 1,000 international units.  You can get it from being exposed to natural sunlight for 20 minutes a day, but we don’t recommend that because of the risk of skin cancer.  (A sunscreen of just 15 SPF filters out 95 percent of the Vitamin D in sunlight.)  Food and drink is another source, but a cup of fortified milk only has 100 international units and a half cup of orange juice contains just 45.  Better to take a daily multivitamin.

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