Depression & The Transition To Menopause

Two studies demonstrate that women with no previous history of depression are at increased risk for depression during the transition into menopause.

Periods of hormonal transition are particularly vulnerable periods for psychiatric illness. Puberty, PMS (or premenstrual dysphoric disorder) and “post partum blues” are common examples. Studies looking at depression in midlife women concluded that symptoms were not due to menopause, rather to stress, relationship problems, empty nest syndrome, other menopausal symptoms or previous histories of depression. Recently, studies are distinguishing between women who are premenopausal (normally menstruating), perimenopausal (transitioning) and menopausal (cessation of menses). The consistent finding is increased depressive symptoms in perimenopausal women.

When a woman’s ovaries no longer have abundant eggs (late 30’s to late 40’s) her period becomes less frequent and she transitions into menopause. This period of time is called “perimenopause”, and is defined by any of the following : a change in the menstrual cycle duration of seven days or a variation in flow (21 days or 35day instead of 28 days); the presence of hot flashes; new onset of PMS (within four years of menopause). The perimenopausal period ends one year after menopause, and it can last up to four years.

Researchers at the University of Pennsylvania followed 231 premenompausal women (aged 35-47) who had never been depressed for eight years. Depression was four times more likely to occur in a woman during her perimenopausal period. It was independently associated with deranged hormonal blood levels, hot flashes and weight gain.

A Harvard Study followed 460 premenopausal women (35-46 years old) who had never been depressed for up to nine years. Perimenopausal women were 2-4 times more likely to become depressed than premenopausal women. Risks were increased by hot flashes independent of negative stressful life events.

Depression symptoms include: sadness, emptiness, decreased pleasure or interest, appetite and weight changes, difficulty sleeping or excessive sleepiness, restlessness or retardation, loss of energy, feelings of worthlessness, inappropriate guilt, difficulty thinking concentrating or deciding, morbid thoughts even without a plan for suicide.

Estrogen has abundant receptors in the brain in addition to bone, uterus, cardiovascular system etc. New onset depression during perimenopause has many treatment options.

Posted in Uncategorized, Women's Mental Health |