Journal of Preventive Medicine

Introduction
The outbreak of COVID-19 caused a global concern and changes in people’s lifestyles. It also caused mood disorders such as anger, confusion and post-traumatic stress disorder. Behavioral changes, ranged from panic to dramatic behaviors, and feelings of loneliness, and disappear, have also been reported. Stress, anxiety and depression are among the most important mental problems in the COVID-19 pandemic. Women are twice as likely to have these disorders than men. Among women, about 20% of those at the reproductive age (15-45) have these disorders for the first time. Reports indicate that vaccination against COVID-19 is associated with a reduction in distress, fear of infection, hospitalization and death, and experience of anxiety, stress, and depression. The purpose of this study is to investigate the depression of women and girls of reproductive age during the spread of COVID-19.

Methods
This is a narrative review study. After searching Ovid, Scopus, Science Direct, Scientific Information Database (SID), PubMed and MagIran databases using keywords depression, women, reproductive age, COVID-19, the related studies published from 2017 to 2019 in English or Persian were selected.

Results
The COVID-19 pandemic had a negative impact on the mental health and increasing the risk of depression. In the general population, the prevalence of depression was higher in women than in men. This difference is related to psychological, social and biological factors. Changes in gonadal hormones and the hypothalamic-pituitary-ovarian axis during menstruation, pregnancy and childbirth, breastfeeding and menopause play a key role in women’s depression. Depression in women can be associated with atypical, somatic and parasuicidal symptoms. Sexual violence, discrimination at work, limitations in social role, and lack of adaptation skills. Symptoms of depression at the beginning of the pandemic were observed in 5% of the female population, and in countries such as United States, even drug abuse was reported. The amount of time staying at home, the presence of anxiety, and marital satisfaction were also the most important factors associated with depression in women during the pandemic. According to Salari et al.’s study, the prevalence of stress, anxiety, and depression in the general population of Iran during the pandemic was 29.6%, 31.9%, and 33.7%, respectively and the probability of infection in women was twice more than that in men.

Conclusion
The results of this research showed that, after the COVID-19 pandemic, postmenopausal women were also classified as a group at risk, due to their psychological responses to the spread of the disease. Widowed and divorced middle-aged women with sleep disorders experience more depression. Due to the decrease in the quality of life (QoL) and physical activity, their communication with peers decreases. Also, due to their lower mental health, it is difficult for them to adapt to critical situations. On the other hand, they cope less with the special conditions of home quarantine than younger peers. Therefore, it is necessary for health care providers to identify and treat these vulnerable groups in time. It is necessary to investigate the QoL of menopausal women and the prevalence of depression in them and provide them with group education through mass media to improve their QoL and adaption to the changes caused by COVID-19.

Ethical Considerations
Compliance with ethical guidelines
The research was conducted with regard to the ethical principles. Informed consent was obtained from all participants.

Funding
This research did not receive any grant from funding agencies in the public, commercial, or non-profit sectors. 

Authors' contributions
All authors contributed equally to the preparation of this paper.

Conflicts of interest
The authors declared no conflict of interest.

 

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