Women During Perimenopause Are More Likely to Experience Depression, Study Finds

According to an analysis published in Journal of Affective Disorders, women are approximately 40% more likely to experience depression in perimenopause than those who aren’t experiencing any menopausal symptoms. This study follows prior research, which found that mindfulness and cognitive behavioral therapy could be an effective form of treatment for non-physical menopausal symptoms.¹

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According to the investigators, the perimenopause stage typically occurs within 3 to 5 years prior to the onset of menopause. During this stage, estrogen and progesterone levels fluctuate, which can result in women experiencing changes in mood, irregular menstrual cycles, and increased feelings of depression. Additionally, this stage tends to occur until 1 year after a woman’s last period and may last for 4 to 8 years in total.¹

This analysis used data from 17 prospective cohort studies with a total of 15,893 women, of which 7 studies and 11,965 participants were included in the final meta-analysis because they reported symptoms of depression. Random effects models and pooled odds ratios (OR) were calculated for depressive symptoms and diagnoses.²

The study findings showed that women in the perimenopausal stage were at an increased risk of elevated depressive symptoms or receiving a diagnosis of depression (OR = 1.40, 95 % CI: 1.21; 1.61, p < .001) compared with women in the pre-menopausal stage. Additionally, there was no significant increase in the risk of depression diagnosis or symptoms shown in women in the post-menopausal period compared with women in the premenopausal period.²

“This study shows that women in the perimenopausal stage are significantly more likely to experience depression than either before or after this stage. Our findings emphasize the importance of acknowledging that women in this life-stage are more vulnerable to experiencing depression,” said senior author Roopal Desai, PhD, BSc, research fellow, psychology and language sciences, University College London (UCL), in a press release. “It also underlines the need to provide support and screening for women to help address their mental health needs effectively.”¹

Additionally, the investigators speculate that reduced estrogen—which has previously shown to affect the metabolism of neurotransmitters—or a significant fluctuation of hormones may trigger the onset or worsening of pre-existing depressive symptoms in women who are at risk. The investigators also note that this supports the concept demonstrated in prior research that the perimenopausal stage could act as a “window of vulnerability” and involves a significant decline in circulating estrogen that is often associated with an increase in depressive symptoms.²

“Combining data from global studies indicates that these findings cannot be attributed to cultural factors or lifestyle changes alone, which have been sometimes used to explain the depressive symptoms that women experience during perimenopause,” said lead study author Yasmeen Badawy, master’s student, psychology and language studies, UCL, in the press release.¹

Limitations of the analysis, according to the authors, include potential inconsistencies in the classification of menopausal stages and different measures for depression, unadjusted effect sizes, an overlap between menopausal symptoms and depressive symptoms, and the inability to include a model that specifically compared the peri- and postmenopausal stages which is a result of a lack of research. Further, only prospective cohort studies were used for the analysis.^1,2

“Women spend years of their lives dealing with menopausal symptoms that can have a huge impact on their wellbeing and quality of life. Our findings show just how significantly the mental health of perimenopausal women can suffer during this time. We need greater awareness and support to ensure they receive appropriate help and care both medically, in the workplace and at home,” said corresponding author Aimee Spector professor, psychology and language Sciences, UCL, in the press release.¹

References

1. University College London. Women are 40% more likely to experience depression during the perimenopause. News release. April 30, 2024. Accessed May 3, 2024. https://www.eurekalert.org/news-releases/1042695

2. Badawy Y, Spector A, Lee Z, Desai R. The risk of depression in the menopausal stages: A systematic review and meta-analysis. J Affect Disord. 2024. doi:10.1016/j.jad.2024.04.041