British researchers have suggested that women who are approaching menopause have a 40% higher risk of suffering from anxiety and depression than those with no menopausal symptoms.
The experts from University College London (UCL) said perimenopausal women had more chance of experiencing these symptoms in the run-up to their periods stopping, with the development of new cases or existing symptoms getting worse.
Menopause typically affects women aged 49 to 52, the point at which women experience the highest rates of depression, reports The Independent.
Common emotional and mental 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.
The latest 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.
The authors did not find a significantly increased risk for depressive symptoms in post-menopausal women, compared with those who were premenopausal, and said one biological reason – discussed in previous research – is that the drop in oestrogen during menopause triggers the onset of new symptoms or the worsening of pre-existing depressive symptoms.
Oestrogen “has been found to affect the metabolism of neurotransmitters (dopamine, norepinephrine, beta-endorphin and serotonin), all of which influence emotional states”.
A previous history of depression has also been linked to depression in women with menopause.
Lead author and University College London Masters student Yasmeen Badawy said: “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.”
In a previous study, the same researchers found that therapy like mindfulness and cognitive behavioural therapy could be an effective form of treatment for non-physical symptoms of the menopause.
The authors said one limitation of their work was that the study was unable to account for whether the women had a previous history of depression.
Study details
The risk of depression in the menopausal stages: A systematic review and meta-analysis
Yasmeen Badawy, Aimee Spector, Zishi Li, Roopal Desai
Published in Journal of Affective Disorders (online) on 18 April 2024
Abstract
Introduction
For many women, menopause transition can be a period of emotional and physical changes, with different menopausal stages associated with varied risk for depressive symptoms and diagnosis. This review aimed to conduct a systematic review and meta-analyses to provide an estimate for the risk of developing a) clinical depression and b) depressive symptoms at different menopausal stages.
Methods
We searched Medline, PsycInfo, Embase and Web of Science from inception to July 2023. Seventeen prospective cohort studies with a total of 16061 women were included in the review, and risk of bias was assessed using the Quality in Prognosis Studies tool (QUIPS). Seven papers with a total of 9141 participants were included in meta-analyses, using random effects models and pooled odds ratios (OR) calculated for depressive symptoms and diagnoses.
Results
Perimenopausal women were found to be at a significantly higher risk for depressive symptoms and diagnoses, compared to premenopausal women (OR = 1.40; 95 % CI: 1.21; 1.61, p < .001). We did not find a significantly increased risk for depressive symptoms or diagnoses in post-menopausal, compared to pre-menopausal women.
Limitations
Studies used different criteria to classify the menopausal stages and different measures for depression, which may have contributed to the heterogeneity seen in some models. We were unable to include a model that compared peri to post-menopause, due to a lack of longitudinal studies comparing the two stages.
Conclusions
The risk of depression in perimenopause, shown in an ethnically diverse sample; highlights the clinical need for screening and support in this potentially vulnerable group.
Journal of Affective Disorders article – The risk of depression in the menopausal stages: A systematic review and meta-analysis (Creative Commons Licence)
https://www.sciencedirect.com/science/article/pii/S0165032724006438
The Independent article – Perimenopausal women ‘40% more likely to suffer depression’ (Open access)
See more from MedicalBrief archives:
Longer oestrogen exposure reduces depression risk in menopause
Women on the pill less likely to suffer depression – US study
Experts warn against HRT for menopausal depression in new guidance