Menopause and Depression Are Strongly Linked

Studies have shown that the menopausal transition, particularly perimenopause and early post-menopause, is correlated with an increased risk of depression due to changing hormone levels. Indeed, the 2018 guidelines for perimenopausal depression, published in Menopause, the journal of the North American Menopause Society (NAMS), state that:

Perimenopause is a vulnerable time for women to develop depressive symptoms and major depressive episodes.
The risk of depressive symptoms is elevated during perimenopause even in women with no history of major depressive disorder.

A new Turkish study published July 1, 2020, in Menopause has confirmed a correlation between the menopausal transition and depression, and an association between certain risk factors and depressive episodes after menopause. The research team looked at 485 post-menopausal Turkish women ages 35 to 78 to assess the frequency of depressive symptoms, the biological, social, and psychological variables involved, and levels of the fear of death. The researchers noted that 41 percent of participants reported experiencing some type of depression. The team has theorized that this percentage is misleadingly low because of the younger age of the participants (average age of 56.3 years).

Traits That Are Associated With an Increase in Depression Around Menopause

The psychosocial and biological variables that the team discovered to be correlated with the risk of developing depressive symptoms are:

Loss of a spouse through divorce or death
Alcohol consumption
Any medical condition requiring continuous medication
Any physical disability
Physician-diagnosed mental illness
Having four or more living children

“The major point here is that women who are under a lot of stress, have major life events, have poor health already, and particularly a history of depression are the ones at higher risk,” says Stephanie Faubion, MD, the medical director of NAMS. She adds, “We know that the biggest risk factor for developing depression in midlife is a previous history of depression.”

No Correlation Between Depression and Fear of Death Was Found

There was no confirmation of a relationship between depression and the fear of death.

The New Research Confirms Previous Results on Midlife Depression in Women

“The findings of this study involving post-menopausal Turkish women are consistent with existing literature and emphasize the high prevalence of depressive symptoms in midlife women, particularly those with a history of depression or anxiety, chronic health conditions, and psychosocial factors such as major stressful life events. Women and the clinicians who care for them need to be aware that the menopause transition is a period of vulnerability in terms of mood,” Dr. Faubion said in a press release regarding the study July 1.

More Research Is Needed to Identify Vulnerable Phases of Years-Long Transition

Faubion, who is also the Penny and Bill George Director of the Mayo Clinic's Center for Women's Health, warns that this study just looked at a group of women who came into the clinic. “All were post-menopausal, but we don’t know where those women were in the menopause transition, whether they were early or many years after, which could skew the results,” she said in a subsequent interview with Everyday Health.

Effective Treatment Is Available; Talk With Your Doctor About Mood Issues

“This study reinforces the fact that we should be monitoring women for mood issues during midlife because we can do something about it,” says Faubion, noting that treatment with an antidepressant is considered first-line therapy for major depression, regardless of when it occurs. But sometimes just dealing with the symptoms of menopause (night sweats, hot flashes, sleep disruption) is enough to improve mood, and hormone therapy (HT) may also have a direct impact on depressive symptoms that occur during the menopause transition and in early post-menopause.