May 5, 2024
The researchers examined data from seven studies involving more than 9,000 women worldwide.
A meta-analysis study (1) suggests that peri-menopausal women have a 40% greater risk of experiencing depression than pre-menopausal women.
It should be noted that, although the terms pre- and peri - menopause are often confused and used interchangeably, scientifically, premenopause coincides with the period from the first menstruation to menopause (which by definition begins one year after the last menstruation). Pre -menopause is therefore a phase that lasts several years, and peri-menopause is a phase that lasts several years . It is contained within this phase, but it is a shorter period, which also includes the actual menopause: in practice, it is the entire phase in which the specific symptoms typical of the biological changes linked to the cessation of fertile age appear.
Experts from University College London (UCL) have found that women may be particularly vulnerable to depression during the lead-up to menopause, with new cases of depression developing or symptoms of existing depressive episodes worsening.
This research therefore highlights the need for support and screening to effectively address women's mental health needs.
Researchers say perimenopause begins about three to four years before menopause, typically between the ages of 49 and 52, a time when women have been shown to experience the highest rates of depression.
Furthermore, no significant increase in the risk of depression was found for postmenopausal women compared to premenopausal women. Other studies have also observed that depressive symptoms actually decrease in the years following menopause, compared to perimenopause.
Common psychological symptoms of perimenopause include low mood, mood swings, anxiety, low self-esteem, and memory and concentration problems. Physical symptoms include hot flashes, sleep problems, heart palpitations, muscle aches, joint pain, and weight gain.
The recent study, published in the Journal of Affective Disorders , examined data from seven studies involving 9,141 women from around the world, including Australia, the United States, China, the Netherlands, and Switzerland.
It concluded that premenopausal women are at "significantly higher risk for symptoms and diagnosis of depression," approximately 40 percent higher than premenopausal women.
A biological cause has been suggested for the increased risk, as the decline in estrogen that women experience during perimenopause triggers the onset of the first symptoms or the worsening of pre-existing symptoms. Estrogen is known to "influence the metabolism of neurotransmitters (dopamine, norepinephrine, endorphins, and serotonin), which in turn influence all emotional states."
It is also added that "night sweats" can also lead to sleep problems, and have some influence, although the issue is controversial, because three studies in this work report that the risk of depressive symptoms remains high in the perimenopausal phase, even after vasomotor symptoms (sweating) have resolved.
A previous history of depression has also been associated with depression in perimenopausal women, while other studies have suggested that caring for both children and elderly parents may also make women more vulnerable.
The new study comes shortly after the researchers' previous publication ( 2 ) , which showed that mindfulness-based therapy and cognitive behavioral therapy could be an effective form of treatment for the non-physical symptoms of menopause.
The study's lead author, Professor Aimee Spector (UCL Psychology & Language Sciences), stated: "Women spend years of their lives dealing with menopausal symptoms, which can have a huge impact on their well-being and quality of life. Our findings show how significantly the mental health of perimenopausal women can suffer during this time. We need greater awareness and support to ensure they receive the appropriate help and care they need, both medically and in the workplace and at home."
A limitation of the authors' work was the difficulty in determining whether or not the women had a previous history of depression.
The study's lead author, Yasmeen Badawy, concluded, however, that "the combination of meta-analysis data indicates that these findings cannot be attributed solely to cultural factors or lifestyle changes, which have sometimes been used in the past to explain the depressive symptoms women experience during perimenopause."