Pregnancy is associated with profound anatomical, physiological, biochemical and endocrine changes that affect multiple organs and systems. Red blood cell (RBC) volume falls during the first 8 weeks of pregnancy, increasing back to non-pregnant levels by 16 weeks and then rising to 30 percentage above non-pregnant levels by term. Marked physiological changes of cardiovascular system, respiratory system, renal system, and gastrointestinal system are significantly observed. During pregnancy the skin undergoes a number of changes, mainly thought to be due to hormonal changes. The additional demand for folate during pregnancy leads to a rapid fall in red cell folate and to a high incidence of megaloblastic anaemia in those women taking anticonvulsant drugs for control of epilepsy. For appendicectomy the type of incision depends on the gestation and the location of the appendix. The routine use of urinalysis for monitoring of glycaemic control during pregnancy is unreliable.

This chapter explores how mood problems relate to the endocrine changes of the natural menopausal transition (MT). It utilizes soundly conducted epidemiological studies to identify any relationship between depressed mood, menopausal status and hormone levels and to determine the relative importance in the aetiology of mid-aged women's depression of hormonal change, chronologic ageing, health problems and other stressors. Clinical conclusions regarding the relationship between menopause and mood are based on a small proportion of self-selecting women who may not be representative of most women's experience. More recent studies such as the USA based Study of 'Women's Health across the Nation' provide an indication of the role of ethnic factors in women's experience of the menopause. The perimenopausal patient requires a dual approach, with the clinician taking into account current research and treatment approaches to menopause and related symptoms, as well as the known research and treatment strategies for mood disorders.