Two new studies say women with no history of depression may be at an increased risk of depressive symptoms and disorders as they enter menopause.
This will be no news to thousands of women who have for centuries suffered from the miserable side effects of the hormonal changes happening to their body often dismissed by the medical profession as some form of female weakness.
Ellen W. Freeman, Ph.D., from the University of Pennsylvania School of Medicine, Philadelphia, and colleagues evaluated data from 231 pre-menopausal women who had no history of depression at the start of the study.
The authors say it has long been recognised that the menopause is for many women a time of increased risk for developing depressive symptoms, but there is little scientific evidence to connect the change in reproductive hormones, menopausal status and mental health.
The participants ranged in age from 35 to 47 and were followed for eight years.
At set intervals, blood samples were obtained to determine hormone levels, and trained research interviewers obtained overall health and demographic information, including any menopausal symptoms experienced.
Depressive symptoms were assessed by using the Center for Epidemiological Studies of Depression scale (CES-D), and the Primary Care Evaluation of Mental Disorders (PRIME-MD) was used to identify clinical diagnoses of depressive disorders.
The authors say that high CES-D scores were more than four times more likely to occur during a woman’s menopausal transition compared with when she was pre-menopausal.
Changes in hormonal levels were significantly linked with high CES-D scores even after adjusting for smoking, body mass index, premenstrual syndrome, hot flashes, poor sleep, health status, employment and marital status.
According to the authors, a depressive disorder was two-and-a-half times more likely to occur in the menopausal transition compared with when the woman was pre-menopausal and the hormone measures were also significantly associated with this outcome.
The researchers say more research is now needed to determine the extent to which these reports of depressed mood are limited to the perimenopausal period and to determine whether the identified risk factors are associated with more persistent depression.
In a related study, Lee S. Cohen, M.D., from Massachusetts General Hospital, Boston, and colleagues from the Harvard Study of Moods and Cycles examined the association between the menopausal transition and onset of first lifetime episode of depression among women with no history of mood disturbance.