A new study published in the journal Menopause helps shed light on why some women appear to be more susceptible to hormone-related depression, particularly during vulnerable times such as childbirth and menopause.
The study focused primarily on the effects of estradiol, the predominant estrogen present during a woman’s reproductive years. Importantly, estradiol helps regulate the synthesis, availability, and metabolism of serotonin, a key neurotransmitter in depression.
Although fluctuations of estradiol during the transition into menopause are very common, the duration of exposure to this hormone throughout the adult years varies widely among women.
Overall, the researchers found a higher risk for depression among women who went through menopause at an earlier age, had fewer menstrual cycles over their entire lifespan, and/or experienced more frequent hot flashes.
On the other hand, women who had been using birth control for a longer period of time appeared to have a reduced risk of depression.
The study titled “Lifelong estradiol exposure and risk of depressive symptoms during the transition to menopause and postmenopause” included data from more than 1,300 regularly menstruating premenopausal women aged 42 to 52 years at study entry.
The primary goal of the study was to understand why some women are more vulnerable to depression, even though all women experience hormone fluctuations. Previous studies have suggested a role for reproductive hormones in causing an increased susceptibility to depression.
A key finding of this study was that longer duration of estrogen exposure from the start of menstruation until the onset of menopause was significantly linked with a reduced risk of depression during the transition to menopause and for up to 10 years postmenopause.
In addition, longer duration of birth control use was associated with a decreased risk of depression. The number of pregnancies or incidence of breastfeeding had no association to depression risk.
“Women are more vulnerable to depressive symptoms during and after the menopause transition because of fluctuating hormone changes,” said Dr. JoAnn Pinkerton, executive director of the North American Menopause Society (NAMS).
“This study additionally found a higher risk for depression in those with earlier menopause, fewer menstrual cycles over lifespan, or more frequent hot flashes. Women and their providers need to recognize symptoms of depression such as mood changes, loss of pleasure, changes in weight or sleep, fatigue, feeling worthless, being unable to make decisions, or feeling persistently sad and take appropriate action.”