The menopause transition is a natural part of the aging process in women, typically beginning in a woman’s 40s or 50s. Although the postmenopause officially occurs when a woman goes 12 months without a period, the transition to the postmenopause, called the perimenopause, can take several years.
As women go through the menopause transition, their hormone production changes. Many women experience symptoms after the transition begins, which can continue once they reach menopause.
In addition to symptoms like hot flashes and insomnia, many women may also experience irritability and mood swings. Some report symptoms of depression and anxiety.
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What Is Depression?
A key symptom of major depression is feelings of sadness and/or low mood that last for two weeks or longer.
It can cause you to lose interest in activities you previously enjoyed and can affect your sleep, appetite, and/or energy level. In the most serious cases, it can lead to suicidal thoughts and/or actions.
Depression is common: 1 in 4 women and 1 in 10 men experience it at some point in their lives. Biological, hormonal, and social factors all may play a part in why depression is more commonly reported in women.
Depression and Menopause
Depression is more commonly reported in women than men. It can occur at any age and for many different reasons.
Many women begin to experience depression early in life, such as adolescence or early adulthood.
Women also may be vulnerable to depression during certain reproductive windows and transitions. Those include:
- The luteal phase of the menstrual cycle
- The postpartum period
- The menopause transition
Many women experience symptoms of depression during the menopausal transition. However, they might not have major depression; symptoms must last at least two weeks for a diagnosis. Still, they are more at risk for a major depressive disorder than they were pre-menopause.
Women who experienced depression earlier in life are vulnerable to depression at these times. Some women may experience depression for the first time during menopause.
Does Menopause Cause Depression?
Some women experience depression during the menopause transition and after menopause. However, that doesn’t mean that menopause causes depression.
According to the North American Menopause Society, most women make the transition into menopause without experiencing a major mood disorder. However, symptoms of anxiety and depression do occur for many women.
Symptoms of menopause — sleep trouble and hormone changes — may play a factor in the higher rate of depression. The North American Menopause Society says women also may consider their mortality during the menopause transition and post-menopause.
Other factors could put women at higher risk of depression during the menopause transition and post-menopause:
- Socioeconomic status (such as unemployment or low education)
- Health conditions (smoking, obesity, other medical conditions)
- Lack of social support
- Stressful life events
How Is Depression Treated?
The most common treatments for depression are medication and psychotherapy:
- Medication: Clinical antidepressants can alleviate symptoms of depression. According to the North American Menopause Society, some antidepressants can also relieve hot flashes. Antidepressants can carry side effects and must always be prescribed by a doctor.
- Psychotherapy: Talking to a mental health professional can help with a wide range of mental health conditions, including depression. The most common type is cognitive-behavioral therapy (CBT). Mindfulness-based therapies are also gaining in popularity and can be effective in helping to treat depression and anxiety.
Often, medication and psychotherapy work in tandem to treat depression.
Hormone therapy is a possible treatment for a subset of women going through depression during the menopause transition, particularly if they have other menopausal symptoms such as hot flashes. However, while hormone therapy has shown some positive results, it also may carry health risks for some women and should be discussed with your doctor.
For more information, call UPMC Western Psychiatric Hospital at 1-877-624-4100 or 412-624-1000.
American Psychiatric Association, What Is Depression? https://www.psychiatry.org/patients-families/depression/what-is-depression
Jennifer L. Gordon, PhD, David R. Rubinow, MD, Tory A. Eisenlohr-Moul, PhD, et al, JAMA Psychiatry, Efficacy of Transdermal Estradiol and Micronized Progesterone in the Prevention of Depressive Symptoms in the Menopause Transition: A Randomized Clinical Trial. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2668205
HelpGuide, Depression in Women. https://www.helpguide.org/articles/depression/depression-in-women.htm
H.M. Kravitz, Encyclopedia of Mental Health, Menopause and Mental Health. https://www.sciencedirect.com/topics/medicine-and-dentistry/involutional-depression
North American Menopause Society, Depression & Menopause. https://www.menopause.org/for-women/menopauseflashes/mental-health-at-menopause/depression-menopause
North American Menopause Society, Depression, Mood Swings, Anxiety. https://www.menopause.org/for-women/sexual-health-menopause-online/causes-of-sexual-problems/depression-mood-swings-anxiety
Claudio Soares, MD, PhD, Menopause, Taking a Fresh Look at Mood, Hormones, and Menopause. https://journals.lww.com/menopausejournal/Fulltext/2020/03000/Taking_a_fresh_look_at_mood,_hormones,_and.16.aspx?casa_token=DlNE4YLQcLMAAAAA:8hAWgolz7tJpxgiNQ5alvowynXDIveLB0LE8FXIb_Uv3GMs_dYZUdhDQcG0ebszDM79Q195VJbiZPYBVcfyGqB-2
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