The association between depression and anti-mullerian hormone in premenopausal women with secondary amenorrhea

Background Mood disturbance has been described in women with menstrual abnormalities. Aims To access the prevalence of depression in patients with secondary amenorrhea (SA), and investigate the relationship between depressive scores and serum anti-Mullerian hormone (AMH) levels among these women. Methods Sixty-six women with SA completed the Centre for Epidemiological Studies-Depression Rating Scales (CES-D) and Hamilton-Depression Rating Scales (HAM-D) in a university hospital. Clinical and biochemical parameters were measured in all individuals, and their associations with depressive scores were analysed. Results Among the 66 patients with SA, 42 (63.6 per cent) were diagnosed with polycystic ovarian syndrome, followed by 14 patients (21.2 per cent) with unexplained chronic anovulation, and the remaining 10 (15.2 per cent) were identified as primary ovarian insufficiency or low ovarian reserve. In the analysis of CES-D Scales, 21 (31.8 per cent) women had scores indicative of depression. Serum AMH levels and antral follicle counts were lower in patients with depressive symptoms than those in patients without depressive symptoms. (4.76 +/- 4.77ng/ml vs. 10.49 +/- 7.52ng/ml (P=0.003), 10.67 +/- 6.20 vs. 14.78 +/- 7.35 (P=0.030), respectively). The CES-D and HAM-D scores also correlated negatively with serum AMH levels after adjusting age, body mass index and androgen level (gamma=-0.429, P=0.001 and gamma=-0.428, P=0.001). Conclusion This cross-sectional study showed that the prevalence of depression in SA patients was high and higher depressive scores were associated with lower serum AMH levels. This observation suggests that decreased AMH level may possibly be linked to a particular spectrum of depression in patients with SA.