Women have high rates of depression compared to men, and various hypotheses have been put forth to account for this difference. Hormonal changes throughout the life course have been posited as one explanation. To fill a gap in knowledge about the experience of hormonal changes related to menopause, Dr. Edith Freeman from the Department of Obstetrics/Gynecology at the University of Pennsylvania and her colleagues tracked 204 women through this life change for 14 years.
The researchers relied on a stratified random sample of households in Philadelphia to identify a sample of women who were about 50% white and 50% African-American. Many of the participants (44%) reported a history of depression at baseline. Those with such a history were also at risk for experiencing depression again through the study period, particularly in the years leading up to menopause, compared to those without such a history. However, even for women with no depression previously, depression reports increased in the years preceding the final period of menopause, and decreased in the eight years following the last menstrual period. Women who had only first experienced depression in their lives as they were transitioning to menopause tended not to suffer from depression after menopause. The conclusion of the study is that a history of depression, more than anything else, predicted depression in the study period. However, it appears that the years immediately preceding menopause put a woman for risk of depression, but that risk is reduced after the final menstrual period.
This study fills a gap in knowledge about the role of hormonal changes during menopause in female depression. Well-known is the fact that depression, like other mental health disorders, often emerges in young adulthood. This study highlights another pattern that has not been closely examined in women.
At a minimum, women can be educated about these results, that the years approaching menopause may put them at increased risk for depression. In this way, they can develop supports and strategies to manage any vulnerability. However, women, even those that have suffered from depression previously, might find it reassuring that they may feel better after they have eventually completed menopause.
Freeman, E., Sammel, M., Boorman, D., & Zhang, R. (2013). Longitudinal pattern of depressive symptoms around natural menopause. JAMA Psychiatry, 7, 36-43.
Signs and symptoms of menopause are usually enough to tell most women that they’ve started the menopausal transition. Typically the cease of menstrual periods accompanied by the above symptoms will determine the diagnosis of menopause. Various tests can be done to further confirm this stage, including follicle-stimulating hormone (FSH) and estrogen (estradiol). Your FSH levels increase and estradiol levels decrease as menopause occurs (Mayo Clinic).