10 Facts about Mood & Menopause

1. During menopause and early postmenopause, there is a 2- to 4- fold increased risk of depression.
2. Mood changes, including depression and anxiety, are among the most common symptoms women experience during perimenopause – the time leading up to a woman’s last menstrual period, can frequently last for several years, and typically starts in a woman’s 40’s.  
3. One in five women ages 40 to 59 is on antidepressant medication. That number rises to one in four women who are 60 years of age or older.
4. Contrast that to the fact that among women ages 18 to 39, one in ten are on antidepressants.
5. Physicians worldwide are concerned that antidepressants are being overprescribed for menopausal symptoms.
6. Hormone replacement therapy can be quite beneficial in improving mood symptoms in perimenopausal and menopausal women.
7. Estrogen (Estradiol) regulates the synthesis, metabolism, and receptor activity of the well-known neurotransmitters linked to mood and depression – serotonin, dopamine, and norepinephrine.  
8. A 2018 study in JAMA Psychiatry included 172 peri- and early postmenopausal women and showed that those women who received hormone replacement therapy had more than a twofold reduction in the risk of developing depressive symptoms.
9. The impact of estradiol treatment on depression appears to be independent of the hormone’s beneficial effect on hot flushes, night sweats, and sleep.
10. In my opinion, a thorough evaluation of a woman’s mood symptoms is necessary to effectively formulate the best treatment plan. Because depression and anxiety can have multiple causes, women deserve a comprehensive evaluation and an integrative treatment plan, including stress reduction, lifestyle modification, the importance of healthy nutrition and exercise, and consideration of hormone replacement therapy, if indicated. I am in favor of using antidepressants when the clinical situation is appropriate, but the knee-jerk reaction of quickly prescribing an antidepressant while ignoring all of the above is often not the best long-term solution.

We’re here to help, at every stage of life.  For an evaluation of your hormones or to discuss any unwanted symptoms of menopause, call 309-692-6838 or see FORM BELOW!  New patients are always welcome.

To Your Health,

Dr. Couri

Sources: 

Gordon, J, et al.  Efficacy of Transdermal Estradiol and Micronized Progesterone in the Prevention of Depressive Symptoms in the Menopause Transition:  A Randomized Clinical Trial.  JAMA Psychiatry.  2018 Feb 1;75(2):149-157.

Rubinow D.R, et al.  Efficacy of Estradiol in Perimenopausal Depression: So Much Promise and So Few Answers: Research Article: Efficacy of Estradiol in Perimenopausal Depression. Depress. Anxiety. 2015;32:539–549.

Bromberger, J., et al.  Depression During and After the Peri-Menopause:  Impact of Hormones, Genetics, and Environmental Determinants of Disease.  Obstet Gynecol Clin North Am. 2018 Dec;45(4):663-678.