Harvard Women's Health Watch

Depression at perimenopause: More than just hormones

A new study is helping to untangle the many contributors to depression during the menopausal transition.

New research has confirmed a link between depression and the menopausal transition, or perimenopause — that time of erratic periods, chaotic hormone fluctuations, disturbed sleep, and, for some, uncomfortable hot flashes. Researchers don't understand all the "whys" yet, but a Seattle-based study should help. Among the findings: little or no correlation between hormone levels and depression during perimenopause. However, a host of other factors have been implicated.

The connection

We reported on the evidence of a relationship between low mood and the menopausal transition in 2006. That year, the Harvard Study of Moods and Cycles reported that one in six participants with no history of depression developed depressive symptoms during perimenopause. Findings were similar in the long-term Penn Ovarian Aging Study: participants with no history of depression were four times more likely to have depressive symptoms during perimenopause than during the preceding years. In addition to hormone fluctuations, researchers have explored the possible influence of psychosocial factors, hot flashes and their impact on sleep, and genetic vulnerabilities. In 2006, the Study of Women's Health Across the Nation identified several genetic mutations that increase the likelihood of perimenopausal depressive symptoms.

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