Research suggests, especially in women with a history of depression or susceptibility to a mood disorder, that reproduction-related hormonal changes raise the risk of depressive episodes.
A few recent studies have concentrated on the perimenopausal period (when women experience skipped and irregular periods), in particular, and found that women in the menopausal transition were up to three times more likely than premenopausal women to report depressive symptoms.
Let’s take a closer look at perimenopause and depression.
In a five-year study of 2,565 women aged 45 to 55 years, prior depression was the variable most predictive of subsequent depression. However, the risk is there for women without depressive histories, as well.
One study, as reported by Barbara Parry, M.D. in “Psychiatric Times,” followed 231 women without depressive histories who were about to enter menopause. Using the Center for Epidemiological Studies of Depression scale, they found that the probability of a high depression score was fourfold greater during the menopausal or periomenopausal phase.
Entering menopause was linked to more than double the risk of a diagnosis for depressive disorder.
Parry writes: “Perimenopausal women in particular are at risk for new onset and recurrence of major depressive episodes. Women with previous histories of PMS or postpartum depression are at increased risk.”
Estrogen and progesterone are two female hormones that rise and fall with each menstrual period. When they decline permanently, as they begin to do in the perimenopausal period, this causes significant mood changes in many women. Estrogen, for example, inhibits cortisol, the stress hormone that triggers a “fight-or-flight” response, and stimulates the feel-good neurotransmitter serotonin. Progesterone has a calming effect and can prevent panic symptoms.
Without these two hormones working to provide a sense of well-being, women are extremely vulnerable to mood dips and clinical depression.
Depression related to perimenopause can be treated with an antidepressant, hormone replacement therapy (HRT), or a combination of both. The effects of HRT in perimenopausal women vary depending on the diagnosis, the menopausal status (whether there are hot flashes), the dose and preparation of estrogen and progesterone, and the duration of the treatment. In some studies estrogen alone did not reduce symptoms of depression; however, estrogen accelerated and enhanced the antidepressant response.
Talk to your doctor about these potential treatments, and the side effects associated with them. It’s important to understand that depression — even due to perimenopause — can be treated successfully in partnership with the right professional.
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Last reviewed: By John M. Grohol, Psy.D. on 7 Jan 2014
Published on PsychCentral.com. All rights reserved.
Borchard, T. (2014). Perimenopause & Depression. Psych Central. Retrieved on March 10, 2014, from http://psychcentral.com/blog/archives/2014/01/07/perimenopause-depression/