Depression risk increases during perimenopause

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A depressed woman (photo: courtesy of Keenan Constance)

Perimenopause means “around menopause” and refers to the transitional years before menopause. Menopause occurs during the first 12 months that a woman goes without having a period for no other health-related reason. Post-menopause begins once a woman has missed her period for 12 straight months. Perimenopause usually starts in the mid-forties, 8 to 10 years before menopause, according to the Cleveland Clinic. As hormone levels fluctuate, menstrual flow and cycle length may begin to change. Symptoms include hot flashes, night sweats, vaginal dryness, headaches, trouble sleeping, and mood changes. Mood changes brought on by fluctuating hormone levels can be a symptom of perimenopause.

A large new study has found that these emotional and mental-health challenges can be quite serious, with the risk of depression increasing by 40 per cent. “Depressive symptoms are very common during this stage of life,” says senior author, Roopal Desai, PhD, a research fellow in the department of clinical educational and health psychology at University College London in England. “Hopefully, our study will encourage women to feel more comfortable to talk about it and access appropriate help and support.”

The results, published in the Journal of Affective Disorders, were based on data from seven studies involving more than 9,000 women from around the globe. Participants ranged in age from 35 to 50 at the start and follow-up periods varied from three to 30 years.

Depressive symptoms were determined using standardized self-reported evaluations that weigh factors such as a lack of interest in doing things, issues with sleep, and feelings of low mood. There was no increased risk of depression observed in postmenopausal women compared with premenopausal women, according to the study.

This current analysis contributes to evidence indicating that women may be more vulnerable to serious mental and emotional health problems as they transition to menopause, notes Fatima Naqvi, MD, an obstetrician-gynecologist. “This research validates what many women have been feeling for a long time — something may be going on with our bodies that is causing depressive episodes,” says Dr. Naqvi, who was not involved in the study. “Menopause isn’t just a sudden event at age 50; it’s a gradual evolution of our bodies. “We’re not the same at 25 as we are at 45”, says Naqvi. “When we hit our forties, it’s the decade of change. While exceptions exist, many of us are dealing with numerous stressors — caregiving, family responsibilities, chronic medical conditions, and societal pressures. This is a crucial decade where patients are urged to pay attention to their health.”

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