Perimenopausal women 40pc more likely to experience depression, research shows

Perimenopausal women are 40 per cent more likely to experience depression, according to new research.

Researchers from University College London (UCL) found women were more vulnerable to depression and anxiety in the months and years leading up to the menopause starting than before this period.

The menopause typically occurs between age 49 and 52 when menstruation has completely stopped, while the perimenopause, when hormonal changes first start to occur, can begin from three to five years earlier.

The menopause had been highlighted previously as the point at which women experience the highest rates of depression.

The new research, published in the Journal of Affective Disorders, examined data from seven studies involving 9,141 women from across the world, including Australia, the US, China, Netherlands and Switzerland.

It found that perimenopausal women were “at a significantly higher risk for depressive symptoms and diagnoses” compared to premenopausal women.

The perimenopause lasts until one year after a woman’s final period – when the menopause technically begins.

Women were 40 per cent more likely to have depression when going through the perimenopause than those who were yet to start the menopausal process, based on results of standard self-assessment tests used to diagnose patients.

Around one in six women suffer from depression at any given time.

The researchers found no significant difference in depression rates between postmenopausal and premenopausal women.

The research team suggested that the drop in the sex hormone oestrogen that occurs during the menopause triggers the onset of new symptoms or the worsening of pre-existing depressive symptoms.

They said oestrogen “has been found to affect the metabolism of neurotransmitters (dopamine, norepinephrine, β-endorphin, and serotonin), all of which influence emotional states”.

Night sweats can also lead to sleep problems, which may also have an influence, though this is not conclusive, they added.

Having a previous history of depression has also been associated with depression in women with menopause, while other studies have said caring for both ageing parents and children may make women more vulnerable.

According to the NHS, common mental health symptoms of menopause and perimenopause include low mood, anxiety, mood swings, low self-esteem and issues with memory and concentration.

Physical symptoms include hot flushes, difficulty sleeping, heart palpitations, muscle aches and joint pains, and weight gain.

‘Lifestyle changes’

Lead author Yasmeen Badawy said the “findings cannot be attributed to cultural factors or lifestyle changes alone”.

Dr Roopal Desai, senior author, said: “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 emphasise the importance of acknowledging that women in this life-stage are more vulnerable to experiencing depression.

“It also underlines the need to provide support and screening for women to help address their mental health needs effectively.”

In a previous study, the same researchers found that therapy – such as mindfulness and cognitive behavioural therapy – could be an effective form of treatment for non-physical symptoms of the menopause.

The National Institute for Health and Care Excellence recently recommended the use of cognitive behavioural therapy (CBT) for menopause symptoms, including hot flushes, and the official guidelines are currently being written.

Draft guidance stated that “more treatment options” were being sought for menopausal women, but critics accused the health body of being patronising and too negative about HRT.

Prof Aimee Spector, a second author from UCL, said: “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.”