Hot flashes, low libido, and joint pain are common physical symptoms of menopause. But mental health changes can also occur during perimenopause and mood disorders, like depression, can emerge.
Now, new research has uncovered just how common it is.
A study published in the Journal of Affective Disorders found that women in perimenopause are about 40 percent more likely to experience depression than premenopausal women.
“Our findings show just how significantly the mental health of perimenopausal women can suffer during this time,” said Dr. Aimee Spector, corresponding author of the study, in a news release. “We need greater awareness and support to ensure they receive appropriate help and care both medically, in the workplace and at home.”
The link between depression and perimenopause
Perimenopause typically begins three to five years before the onset of menopause, and common mental health symptoms of perimenopause include poor mood, anxiety, low self-esteem, mood swings, and issues with memory and concentration, the researchers stated.
For this study, researchers examined data from seven studies involving 9,141 women from across the globe, including the United States, China, Australia, the Netherlands, and Switzerland. The goal was to better understand and provide “an estimate for the risk of developing clinical, diagnosed depression or depressive symptoms” at different stages in menopause.
Researchers did not find a significantly increased risk for depression in postmenopausal women, when compared with those who were premenopausal.
“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 author, Yasmeen Badawy in a news release.
Estrogen’s role in depression
The study authors suggested that one reason for an increase in depression in perimenopausal women is the natural drop in estrogen during this time. This can trigger depressive symptoms or worsen pre-existing symptoms for some women.
Estrogen “has been found to affect the metabolism of neurotransmitters (dopamine, norepinephrine, endorphin, and serotonin), all of which influence emotional states,” researchers said.
During perimenopause women’s estrogen and progesterone levels begin to fluctuate, causing them to experience mood changes, irregular menstrual cycles, and other menopausal symptoms that can include increased feelings of depression or depressive symptoms.
However, researchers noted that a limitation of their study was that it was unable to account for whether the participants had a previous history of depression, which has been found to be relevant in previous studies. And researchers were also not able to compare the reported symptoms of participants between perimenopausal and postmenopausal women.
While medical or psychological intervention can be recommended for treatment of depression, a previous study conducted by the same researchers, found mindfulness and cognitive behavioral therapy could be effective for non-physical symptoms of menopause.
“Women spend years of their lives dealing with menopausal symptoms that can have a huge impact on their wellbeing and quality of life,” said Spector. “Our findings show just how significantly the mental health of perimenopausal women can suffer during this time.
How to prioritize your mental health
A woman’s mental health can be impacted in many different ways during perimenopause. Symptoms such as anxiety, irritability, difficulty concentrating, memory problems, and lack of sleep can all occur during this time. This can exacerbate depressive symptoms or even bring them on.
Talk to your provider about hormone therapy, which is a proven treatment for menopause symptoms.
Eating well, getting as much sleep as you can, and being physically active are also all proven ways to support your health. Yoga, meditation, and daily walks can help as well.
It’s also important to avoid limit unhealthy behaviors during perimenopause such as smoking, excessive alcohol use, and eating foods high in saturated fats or sodium.
If depressive symptoms persist, seek help from a mental health provider who can guide you through additional treatment options such as therapy or antidepressants.