The focus of this research database is on how stress affects women's health,

and options for treatment using mind-body therapies. 

If you are not a health care professional, see new "Medical Glossary" below.  

To obtain full summaries of the articles, see "How to Get Abstracts" below. 

Historical summary of views of menopause. First paper on this written in 1774, word "menopause" coined in 1812, and first popular women's guidebooks on the subject in the early 1800s "sold out in a few months". Early view was that with age the uterus became too weak to expel the vile humors of the menstrual fluid, which backed up to turn to fat, breast and uterine tumors, and many other diseases, creating a "woman's hell". Later view was that the menopause was more of a natural process (although a women should be at that point asexual), but that the problem was the perimenopause, when the uterus, felt connected to the nervous system, went through a "tumultuous state of utmost irritation and disorder" which was then transferred to the rest of the body. "She became more sensitive, agitated, and easily afflicted by disagreeable incidents; pleasure was indifferent to her; she became sad and easily grew upset against her children, her husband, those around her, sometimes yielding to violent outbursts." It was also remarked that simple country women suffered few or no complaints compared to upper-class urban women, who "constantly exposed body and mind to all kinds of disturbances and irritations. The demands of social life, the premature arousal of sexual desire, masturbation and loose sexual mores, the reading of bad novels, the unnatural state of excitation caused by concerts and theater, dances and gambling, and overly rich and spicy food, the abuse of coffee, tea, tobacco, wine and spirits--all this created an unrelenting state of over-stimulation. It was made even worse by a life of idleness spent reclining on cushions and chaise lounges instead of attending to domestic duties, by an unwillingness to breast-feed, and by the bad air in overcrowded salons."

1999 Bull Hist Med 73;3:404-28

Stolberg, M.

11910608 JA

In a longitudinal study of Swedish women, more than half held a positive view of menopause as a time associated with increased self-awareness and a stronger personal identity. Hot flashes and joint pains were associated with menopausal status, but all other symptoms were significantly related to psychosocial factors, life-style and attitude toward menopause.

2000 Climacteric 3;1:33-42

Olofsson, A. S. and Collins, A.

11306201 JA

In an internet-based survey of menopausal women, most frequent symptoms were fatigue, muscle and joint aches, and impatience. Degree of symptoms were positively associated with anxiety and stress levels. Many women did not consult with their healthcare providers regarding their symptoms. Women received health information from: magazines and books 80%, other women 60%, internet 60%, TV and radio 41%, and seminars 21%.

2001 Maturitas 38;2:129-36

Conboy, L., Domar, A., and O'Connell, E.

11856658 R,T

Overview of clinical physical and psychological symptoms due to erratic and sometimes abrupt decline in ovarian steroid hormones during perimenopause and menopause. Symptoms that may be associated include insomnia, fatigue, headaches, loss of libido, muscle and joint pain, weight gain, insulin resistance and glucose intolerance, anxiety and depression, mood changes, and cognitive changes including memory loss.

2002 Prim Care 29;1:43-67, vi

Vliet, E. L.

8829703 R,T

The perimenopause can last for several years, the consequences of which are numerous and include vasomotor symptoms, declining bone mass, urogenital changes, infertility, irregular uterine bleeding and psychosexual dysfunction. In addition, risk factors for heart disease and cancers must be assessed and managed. This is a challenging time for patients and their doctors.

1996 Int J Fertil Menopausal Stud 41;2:85-9

Sulak, P. J.

8133790 JA

In this study of over 500 Danish women, the menopausal transition was significantly associated with hot flushes, moodiness and fatigue.

1993 Maturitas 17;3:155-66

Koster, A. and Davidsen, M.

8412889 JA

In a random survey of 2000 Australian women, vasomotor symptoms and general physical symptoms were associated with menopause. Women with better general health, lower levels of interpersonal stress, absence of PMS, non-smokers, exercisers at least once a week, and those with a positive attitude to ageing and menopause had significantly fewer symptoms.

1993 Med J Aust 159;4:232-6

Dennerstein, L., Smith, A. M., Morse, C., Burger, H., Green, A., Hopper, J., and Ryan, M.

Review of the sequence of hormonal changes that occur during the menopausal transition. Hormone levels frequently vary markedly, therefore measures of FSH and estradiol are unreliable guides to menopausal status.

2002 Recent Prog Horm Res 57;257-75

Burger, H. G., Dudley, E. C., Robertson, D. M., and Dennerstein, L.

11281008 R,T

Thorough literature review on the effects of estrogen on the brain, with potentially favorable influences on mood and cognition in older women.

1998 J Gend Specif Med 1;2:23-7

Small, G. W.

11279851 R

Review of effects of estrogen on the human brain throughout the life cycle. Ovarian hormones help regulate synapse turnover in the hippocampus (related to memory and emotion), and have widespread effects on catecholamines, the cholinergic system and serotonin pathways.

1998 J Gend Specif Med 1;1:33-41

McEwen, B. S.

11919305 CT

Genetic differences in estrogen receptor alpha have been identified. In one type, present in 18.9% of screened women, women who were given estrogen experienced HDL increases twice as large as other women, even in the face of adding progesterone, and regardless of racial and ethnic groups. [Importance of considering individual genetic differences in the ongoing hormone controversy--one more factor in the decision.]

2002 N Engl J Med 346;13:967-74

Herrington, D. M., Howard, T. D., Hawkins, G. A., Reboussin, D. M., Xu, J., Zheng, S. L., Brosnihan, K. B., Meyers, D. A., and Bleecker, E. R.

1572469 JA

Estrogen levels directly and significantly correlate with cerebral blood flow velocity and pulsatility index.

1992 Fertil Steril 57;5:1022-5

Shamma, F. N., Fayad, P., Brass, L., and Sarrel, P.

11400218 JA

Married women report a later mean age at menopause than single or divorced women. Possible role of pheromone influence discussed.

2001 Am J Human Biol 13;4:479-85

Sievert, L. L., Waddle, D., and Canali, K.

11129757 JA

In 749 Californian women not taking corticosteroids or postmenopausal hormones, with mean age 72 years, those with higher baseline cortisol levels scored significantly worse on verbal memory.

2000 J Am Geriatr Soc 48;12:1655-8

Greendale, G. A., Kritz-Silverstein, D., Seeman, T., and Barrett-Connor, E.

7671013 JA

[Article in French] Per abstract, authors suggest the possibility that stressful life events could increase follicular cytokines and bring about an autoimmune origin for premature ovarian failure.

1995 C R Acad Sci III 318;6:691-8

Letur-Konirsch, H., Raoul-Duval, A., Cabau, A., Bomsel-Helmreich, O., al Mufti, W., and Homo-Delarche, F.

2756076 JA

Menopausal women not on hormones showed increased heart rate, systolic blood pressure and epinephrine levels in response to laboratory stressors compared to premenopausal women.

1989 Psychophysiology 26;3:270-80

Saab, P. G., Matthews, K. A., Stoney, C. M., and McDonald, R. H.

9549049 JA

Menopausal women on estrogen replacement had higher growth hormone levels and enhanced lymphocyte responsiveness than women not on replacement. Natural killer cell activity was the same in both groups.

1997 Endocrine 7;2:227-33

Malarkey, W. B., Burleson, M., Cacioppo, J. T., Poehlmann, K., Glaser, R., and Kiecolt-Glaser, J. K.

9492234 JA

Long-term ERT was associated with decreased reactivity to stress and increased T cell immune function.

1998 Psychosom Med 60;1:17-25

Burleson, M. H., Malarkey, W. B., Cacioppo, J. T., Poehlmann, K. M., Kiecolt-Glaser, J. K., Berntson, G. G., and Glaser, R.

11352127 RCT

Women on ERT had a significantly decreased response to cardiovascular stress than women not on estrogen. However, when women not on ERT were randomly given estrogen for 6 weeks, no improvement in reactivity was observed. Proposed explanations were that the dose and duration were insufficient, or that women who chose to use ERT had different physical or lifestyle characteristics.

2001 Psychophysiology 38;3:391-8

Matthews, K. A., Flory, J. D., Owens, J. F., Harris, K. F., and Berga, S. L.

8252693 JA

Menopausal women not on hormones demonstrated increased systolic blood pressure to a laboratory stressor compared to premenopausal women. Large blood pressure responses during a public speaking stress were associated with high cholesterol levels.

1993 Circulation 88;6:2794-802

Owens, J. F., Stoney, C. M., and Matthews, K. A.

11063980 CT

Administration of estradiol and progesterone to five postmenopausal women increased serotonin binding receptors throughout the brain frontal cortex by 21.2%.

2000 Biol Psychiatry 48;8:854-60

Moses, E. L., Drevets, W. C., Smith, G., Mathis, C. A., Kalro, B. N., Butters, M. A., Leondires, M. P., Greer, P. J., Lopresti, B., Loucks, T. L., and Berga, S. L.

11909568 JA

In pre and postmenopausal women with similar age, race, weight and blood pressure, postmenopausal women had significantly increased peripheral resistance, less nocturnal decreases in BP, and evidence of early left ventricular wall thickening.

2002 Am J Cardiol 89;7:830-3

Hinderliter, A. L., Sherwood, A., Blumenthal, J. A., Light, K. C., Girdler, S. S., McFetridge, J., Johnson, K., and Waugh, R.

11212970 RCT

Postmenopausal women on estrogen replacement over six months had significantly reduced vascular resistance and modest blood pressure reductions, increased stroke volume and decreases in left ventricular wall thickness, compared to a group not on replacement.

2001 J Hypertens 19;2:269-78

Light, K. C., Hinderliter, A. L., West, S. G., Grewen, K. M., Steege, J. F., Sherwood, A., and Girdler, S. S.

In discussion with 11 midlife Canadian women, "confusion" emerged as one of the major themes. This confusion related to the women themselves ("Am I losing my mind? Why am I feeling this way? I couldn't remember things, I couldn't concentrate...my tolerance level was gone. It was scary."), in society's negative attitudes about aging women ("I felt very insecure and vulnerable and I just felt really bad about myself...I felt I'd lost myself"), and lack of consistent health-related information ("The type of ads that pharmaceuticals put out for the doctors journals, it's usually something about 'She's bitchy, flying off the handle, and can't agree with anybody, is confrontational, has loads of problems', and that sort of thing. 'But if she takes Premarin she just becomes a regular pussycat', sexy probably. It's whatever the doctors think a women should be--sexy and submissive probably.").

2000 Issues Ment Health Nurs 21;8:745-64

Banister, E. M.

8887186 R,T

Author proposes a unifying theory: that the brain is an estrogen target organ, and that during states of falling estrogen levels, found clinically during times of PMS, postpartum blues, perimenopausal transition and menopause, there are reported similar symptoms of depression, sleep disturbance, irritability, anxiety and panic, memory and cognitive dysfunction and a decreased sense of well-being.

1996 J Reprod Med 41;9:633-9

Arpels, J. C.

11225691 JA

In the early phase of menopausal transition, positive mood was significantly adversely influenced by interpersonal stress levels and negative attitudes to aging. The most important predictor of positive mood in late perimenopause was positive mood in premenopause. Other factors were major life events, daily hassles, marital status and work satisfaction.

2001 J Nerv Ment Dis 189;2:84-9

Dennerstein, L., Lehert, P., Dudley, E., and Guthrie, J.

10579597 JA

In 354 Australian women followed prospectively, negative mood was not related to natural menopause, estrogen levels or age. Negative mood was significantly predicted by prior PMS, negative attitudes toward ageing and menopause, and parity of one. During follow-up, negative mood was significantly worsened by bothersome symptoms, poor health, negative feelings for partner, no partner, low exercise, smoking, and high stress.

1999 J Nerv Ment Dis 187;11:685-91

Dennerstein, L., Lehert, P., Burger, H., and Dudley, E.

9203229 MA

In a meta-analysis, HRT was effective in reducing depressed mood in menopausal women. Androgen alone and in combination with estrogen also decreased depressed mood.

1997 Psychoneuroendocrinology 22;3:189-212

Zweifel, J. E. and O'Brien, W. H.

10942479 RCT

In a double-blind study of perimenopausal women with depression, estradiol replacement for three weeks resulted in significant improvement in 80% vs. 22% in a control group. Results were independent of hot flash status.

2000 Am J Obstet Gynecol 183;2:414-20

Schmidt, P. J., Nieman, L., Danaceau, M. A., Tobin, M. B., Roca, C. A., Murphy, J. H., and Rubinow, D. R.

2197957 R,T

Review of effects of depression, anxiety and stress on postmenopausal estrogen and catecholamine levels.

1990 Ann N Y Acad Sci 592;95-113; discussion 123-33

Ballinger, S.

10914619 JA

Women's perceived memory functioning was more closely related to perceived health, depression and stress, than to perimenopausal state or age.

2000 Menopause 7;4:257-65

Woods, N. F., Mitchell, E. S., and Adams, C.

10729757 JA

Severity of menopausal symptoms correlated positively with the number of undesirable life events. Those who used avoidance-coping (more vulnerable to stress) also had more symptoms.

2000 Gynecol Obstet Invest 49;3:170-8

Igarashi, M., Saito, H., Morioka, Y., Oiji, A., Nadaoka, T., and Kashiwakura, M.

11304879 R,T

Article describes physiologic, psychologic and sexual well-being in relation to the abrupt situation of surgical menopause, and the impact of estrogen/androgen therapy.

2001 J Reprod Med 46;3 Suppl:317-24

Taylor, M.

11076338 JA

A survey of British women who had experienced spontaneous premature menopause before the age of 40 showed significantly more depression and perceived stress, lower levels of self-esteem and life satisfaction, and more negative dimensions of sexuality than the general population.

2000 J Psychosom Obstet Gynaecol 21;3:167-74

Liao, K. L., Wood, N., and Conway, G. S.

Menopausal women who used the relaxation response significantly reduced hot flash intensity (but not frequency), and symptoms of anxiety and depression.

1996 J Psychosom Obstet Gynaecol 17;4:202-7

Irvin, J. H., Domar, A. D., Clark, C., Zuttermeister, P. C., and Friedman, R.

9489686 CT

Small pilot study of six women who had a mean reduction in hot flushes of 73% by utilizing applied relaxation.

1997 J Behav Ther Exp Psychiatry 28;4:251-61

Wijma, K., Melin, A., Nedstrand, E., and Hammar, M.

6394631 RCT

In this small study, progressive muscle relaxation, but not biofeedback, significantly decreased hot flash frequency.

1984 J Consult Clin Psychol 52;6:1072-9

Germaine, L. M. and Freedman, R. R.

1497048 RCT

Paced respiration (slow, deep abdominal breathing at 6-8 cycles/min.) significantly decreased frequency of hot flushes, with no effect of progressive muscle relaxation or biofeedback.

1992 Am J Obstet Gynecol 167;2:436-9

Freedman, R. R. and Woodward, S.

11876431 JA

The alternative therapies for menopause that women made use of and discussed in peri- and menopausal focus groups were herbal preparations, vitamin supplements, "healthy living" (diet and exercise), and mind/body practices.

2001 J Women Aging 13;4:21-37

Richter, D. L, Corwin, S. J, Rheaume, C. E, and McKeown, R. E

7925765 R,T

Article reviews effects of stress, exercise, dietary intake and cognitive therapies for menopausal symptoms. Suggestions for future research included.

1994 Exp Gerontol 29;3-4:469-76

Shaver, J. L.