Menopausal transition and depression: who is at risk and how to treat it?

Abstract

The menopausal transition may impose a challenge to clinicians and health professionals who are invested in improving women’s quality of life; after all, this period in life is commonly marked by significant hormone fluctuations accompanied by bothersome vasomotor symptoms (e.g., hot flushes and night sweats) and other somatic complaints. In addition, more recent epidemiologic data demonstrate that some women transitioning to menopause may be at higher risk for developing depression when compared with their risk during premenopausal years; this increased risk appears to be true even among those who had never experienced depression before. In this article, putative contributing factors for this window of vulnerability for depression during the menopausal transition are critically reviewed. Hormonal and nonhormonal factors that may contribute to the occurrence of physical and/or psychiatric complaints during the menopausal transition are discussed. Lastly, existing evidence-based treatment strategies are summarized.

Keywords::

• antidepressants
• depression
• estrogens
• hormone therapies
• hot flushes
• menopause
• perimenopause

Financial & competing interests disclosure

Claudio Soares has received Grant/Research Support from Eli Lilly, AstraZeneca, National Alliance for Research on Schizophrenia and Depression, Physicians Services, Incorporated, and Allergen; he has received honoraria as research consultant for Glaxosmithkline, Wyeth Pharmaceuticals, Forest Laboratories, Lundbeck, Sepracor Inc. and Neurocrine. Claudio Soares is part of the Speaker's Bureau of Glaxosmithkline, AstraZeneca, Wyeth Pharmaceuticals, Forest Laboratories, Bayer, Lundbeck and Sepracor Inc.

The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.