Depression In Menopause

depression in menopause

As women traverse through the menopause transition and eventually reach menopause, they encounter a period often marked by hormonal fluctuations and various social stressors, all of which can contribute to low mood and depression. While the connection between hormonal changes and mood disturbances during this time is apparent, it’s equally crucial to recognise the impact of social factors such as poverty, intimate partner violence, and ageism on women’s mental health.

Understanding Depression and Low Mood

Depression, clinically known as major depressive disorder, encompasses a range of symptoms including sleep disturbances, decreased interest or pleasure, feelings of worthlessness, changes in energy levels, impaired concentration, appetite changes, psychomotor disturbances, suicidal thoughts, and depressed mood. Distinguishing between major depression and low mood, which might not meet the diagnostic criteria but still affects quality of life, is essential.

Research from the UK suggests that approximately 20% of women experience symptoms of depression during the menopause transition and menopause. However, studies vary due to differences in methodologies and definitions, making it challenging to determine an exact prevalence rate.

Risk Factors 

Several factors contribute to the risk of depression during menopause. These include a history of depression, frequent hot flashes and night sweats, reduced physical activity, poor sleep quality, low social support, stressful life events, anxiety, and previous experiences with premenstrual dysphoric disorder (PMDD) or postpartum depression.

A significant finding from UK research is the strong association between previous depression and an increased risk of depression during the menopause transition. Women with a history of depression are nearly twice as likely to experience depression during menopause compared to those without such a history.

Moreover, there is evidence suggesting a potential link between hormone fluctuations and depression. For instance, studies have shown that women who undergo hormone replacement therapy (HRT) may experience a reduction in depressive symptoms, particularly if they have a history of depression.

 

Treatment Options 

Menopause Hormone Therapy (MHT)

Recent UK studies have explored the use of oestrogen therapy as a potential treatment for depression during menopause. While larger clinical trials are needed, preliminary findings suggest that oestrogen supplementation may offer benefits for women experiencing depression, especially those with a history of the condition. However, it’s essential to weigh the potential risks and benefits of menopause hormone therapy on an individual basis.

 

Antidepressants

Antidepressants remain a valuable treatment option for depression during menopause. Contrary to some misconceptions, these medications can be effective and safe when prescribed appropriately. In fact, combining antidepressants with menopause hormone therapy may yield even better results for managing depression symptoms during this phase of life.

 

Conclusion

Depression during the menopause transition and menopause is a complex phenomenon influenced by hormonal changes, social factors, and individual predispositions. By understanding the risk factors and available treatment options, healthcare providers can offer personalised care to support women through this challenging yet transformative stage of life. Further research, particularly from the UK, is needed to elucidate the underlying mechanisms and optimise treatment approaches for depression in menopause.

 

References:

https://www.swanstudy.org/

https://research.reading.ac.uk/research-blog/menopause-hrt-linked-to-depression-heres-what-the-evidence-actually-says/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4753939/#:~:text=The%20major%20finding%20of%20our,sleep%20disorder%2C%20and%20bipolar%20disorder.