Depression and menopause
Any woman of a certain age will tell you that menopause is no fun. Most will talk of physical complaints such as the notorious hot flashes and sleep loss as well as a myriad of other symptoms that can go along with this transitional stage in life.
Moodiness is also often touted as part of the menopausal package and a recent longitudinal study funded by the US National Institutes of Health has now found that clinical depression during the perimenopausal period can be added to the list of potential issues women face at this time.
Although it has been known for sometime that depression can be triggered by hormonal changes in women including the post partum period as well as the various stages of menopause, it was unclear how susceptible women really are or the exact role of hormones in the mood changes.
This study found that many women with no history of depression develop the condition during the months and years leading to menopause and it also found that hormone changes seem to be linked with the development of depression in these women.
More than 200 women with no history of depression were followed for eight years during the course of this study. Ranging in age from 35 to 47, the women were interviewed 10 times over the eight years regarding their menstrual cycle dates, reproductive history and general health. In addition, they were assessed regularly for depressive symptoms and clinical depression.
Blood samples were also taken to analyze levels of key hormones including luteinizing hormone (LH), follicle stimulating hormone (FSH) and estradiol.
Finally, investigators analyzed all the information to determine whether participants had developed depression during the study and whether depression was tied to hormone levels at the time.
Interestingly, half of the women had high depression scores at least once during the study and one quarter met the full criteria for clinical depression. The study found that they were four times more likely to experience depressive symptoms during the transition to menopause than when they were premenopausal. This was a very significant number and showed a definite correlation between onset of depression and menopause.
Women were also more than twice as likely to have full clinical depression while experiencing the transition to menopause than when they were premenopausal.
Hormonal links were also confirmed during the study as increased levels of LH and FSH as well as variability in these and estradiol were significantly linked with depressive symptoms and a full clinical diagnosis. For example, the women who were diagnosed with clinical depression were nine times more likely to have elevated FSH levels and five times more likely to have elevated LH levels upon diagnosis than before symptoms began.
These strong links between hormonal levels and onset of depression in women with no previous history of the condition indicate a need for more research into depression during the transition to menopause so that better screening and treatment for this kind of depression can be found. These women with no prior history of depression are more likely to be seeing their family physician than a psychiatrist. It is important that these depressive symptoms be recognized and treated.
Until targeted treatments and studies can be carried out, traditional treatment for depression can still be effective even if hormonal changes are what triggered the mood disorder. Speak with your doctor to learn your options.
Several depression studies are also underway at Okanagan Clinical Trials. Contact us to learn if you might be eligible to participate.