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    Nearing Menopause? Depression a Risk

    Researchers Say Hormonal Changes Appear to Play a Role
    By
    WebMD Health News
    Reviewed by Louise Chang, MD

    April 3, 2006 -- Women approaching menopause are at increased risk for depression, and two new studies offer some of the strongest evidence yet that hormonal changes may be at least partially to blame.

    Both studies followed women through the transition to menopause, known as perimenopause. None of the women had a history of depression prior to this time in their lives, but their risk of developing symptoms of depression greatly increased during these years.

    The two studies are published in the April issue of the journal Archives of General Psychiatry.

    The findings argue in favor of aggressive treatment of both menopausal symptoms and depression symptoms occurring during the transition to menopause, researchers say.

    "There is a tendency to dismiss symptoms of depression as part and parcel of this transition, but they shouldn't be discounted," Massachusetts General Hospital researcher Lee S. Cohen, MD, tells WebMD.

    "From a public health point of view, depression is a substantial illness with significant morbidity for patients and their families. This is a real problem, but the good news is that it is a problem that can be managed."

    Risk of Depression

    Cohen and colleagues followed 460 Boston women between the ages of 36 and 45 for up to six years. All of the women were premenopausal at enrollment, meaning that they still had regular periods or had not undergone other changes indicative of transition to menopause.

    None of the 460 women had ever been diagnosed with major depression. But those who entered perimenopause during the study period were almost twice as likely as those who didn't to develop significant symptoms of depression.

    The risk was greater in perimenopausal women who also had hot flashes, but it was still greatly elevated in those who did not have this and other common symptoms associated with transitioning to menopause, Cohen says.

    Role of PMS and Smoking

    In the second, similarly designed study, University of Pennsylvania School of Medicine researchers followed 231 women between the ages of 35 and 47 for eight years.

    Once again, the women were premenopausal at entry and they had no prior history of major depression.

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