Can Menopause Cause Depression in Women?
As you prepare for midlife, your body changes and progresses toward menopause. This happens between ages 45 and 55. During this phase, you may experience a hollow feeling and notice frequent mood swings, pointing to depression. The hot flashes and sleepless nights make it even worse, but you’re not alone.
In a 2023 report, the World Health Organization (WHO) says approximately 280 million people worldwide have depression, and women are more likely to develop one than men. According to a 2010 study published in Menopause, this probability is three times higher in perimenopausal than in premenopausal women.
Perimenopause is the time leading to menopause. During this phase, females experience hormonal and physical changes. Also, menopausal symptoms start to develop. This article will answer the question "Can menopause cause depression in women?" Keep reading to find out.
The Connection Between Depression and Menopause
During perimenopause, estrogen levels rises and falls causing mood changes. Primarily, researchers link menopausal depression to fluctuations in estrogen levels and other reproductive hormones.
"Women are especially susceptible to depression when their estrogen levels drop, as estrogen helps regulate our serotonin–the feel-good neurotransmitter" says Sue May, menopause coach and expert, founder of Midlife Evolved. "Low progesterone levels also affect our ability to sleep, which can cause anxiety and depression", she added.
While this is a strong cause of menopausal depression, some studies suggest other secondary causes. For example, in a 2018 study focusing on why some women are more susceptible to depression during perimenopause, researchers found that the risk for depression was connected to reproductive aging.
They also suggested that depression wasn't limited to hormonal changes alone but included genetic, behavioral, and social factors.
"Women going through menopause have a great storm of changes going on at once," says Sue, "hormonal fluctuations and drops often being part of the sandwich generation caring for both aging parents and kids, and midlife can also be a time when we have worked our way into stressful careers."
Another reason for menopause depression may also come from the fear of losing youthfulness.
"In some cultures, for instance, African cultures, menstruation is seen as a sign of youthfulness, while menopause is seen as old age, which is why some people would do anything to keep it," says Dr. Nsisong Asanga, a medical doctor.
These factors plus fluctuations in your hormones can pressure your mental health and may lead to depression.
Symptoms of Menopause Depression
A history of depression may increase your chances of experiencing it during perimenopause and menopause. So you should talk to your doctor once you notice the following symptoms:
- suicidal thoughts
- persistent feeling of sadness, hopelessness, and losing interest in things you enjoy doing
- overeating or lack of appetite
- oversleeping or lack of sleep
- fatigue and lack of motivation
- difficulty absorbing information and making decisions
- constantly feeling irritated
- withdrawal from activities
- lack of self-care
"Depression during menopause can manifest itself in different ways. For example, hormone fluctuations can cause something called menopausal rage which is anger that can appear out of nowhere,"-Coach Sue.
How to Overcome Menopause Depression
The first way to overcome menopause depression is by understanding your diagnosis.
"The word depression is often abused. What many people call depression could just be a bad mood, so try and talk to a professional," says Dr. Asanga.
That said, these are some of the ways to treat menopause depression:
Antidepressants
Antidepressants are medications used in treating anxiety disorders, mood swings, depression, panic attacks, and insomnia. These medications work by increasing neurotransmitters and are very useful in managing symptoms of depression.
A 2020 review published in Scientific Reports also showed that antidepressants were good for treating major depressive disorder during menopause.
It focused on studies using selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs)—antidepressants. However, you should properly check to be sure if taking antidepressants is best for you.
"For me, this would be the last choice as these medications tend to be overprescribed (1 in 5 women 40-59 yrs old are on some sort of antidepressant medication), says Sue. Yet she suggests that if you've tried one to three alternative treatments with no success, this may be the next option.
However, "this should be used with talk therapy and works best when combined with some lifestyle changes so we can look at relieving depression from every angle", she says.
Hormone Replacement Therapy
Hormone replacement therapy is also helpful in treating perimenopausal and menopausal depression. The idea is to administer estrogen, increasing its levels in your body. In a 2018 JAMA Psychiatry study, researchers randomly grouped 172 perimenopausal and early postmenopausal women, with some sets given hormonal therapy, and other sets a placebo.
After 12 months, they discovered that 32.3% of women who took placebos developed depressive symptoms while only 17.3% of women on hormonal replacement therapy developed one. This study confirms that hormonal replacement therapy may help reduce menopausal depression.
However, the downside to this therapy is that it increases the risk of cardiovascular disease and cancer, and withdrawal of these hormones can cause depressive symptoms to resurface. Other side effects include breast tenderness, feeling sick and vaginal bleeding.
Lifestyle Change
Your risk for osteoporosis and heart disease increases during perimenopause, which may stress your mental health. So, you’ll need a lifestyle change. Eat healthy, exercise, and become more active. These routines would help avoid stress that could affect your mental health.
Dr. Asanga recommends 22-30 mins of vigorous activity according to the American College of Sports Medicine (ACSM)'s guidelines, "Anything to get your heart rate up. This would make you feel better and active, instead of doom scrolling and falling into depression."
Also, "research has shown some foods like chocolate and banana have been associated with improving one's mood."
Some women experience insomnia during menopause and perimenopause, so it's important to have enough sleep and try relaxation techniques. Add limiting caffeine and alcohol consumption. These are just some healthy habits you need to adopt to help manage depressive symptoms during menopause.
Sue also says, "We can't prevent hormone fluctuations, but we can pay attention to these lifestyle changes and be sure we have the support in place when we need it most"
Seeking Help
Once you notice symptoms of depression, it's time to reach out for help. Don't suck it in.
Sue advises that it is crucial that women seek support if they are experiencing depression during menopause. "It's incredibly common, but too many women are not seeking the support they deserve and instead leaving their careers (or worse) when we know there are many proven methods and strategies to help them through this challenging time."
Thankfully, these mood fluctuations are treatable, and if they start to affect your productivity during day-to-day activities. It's time to seek help.
Sources:
- Depressive disorder (Depression).
https://www.who.int/news-room/fact-sheets/detail/depression#:~:text=Women%20are%20more%20likely%20to,world%20have%20depression%20(1). - Freeman EW. ( 2010) Associations of depression with the transition to menopause. Menopause.
https://journals.lww.com/menopausejournal/Abstract/2010/17040/Associations_of_depression_with_the_transition_to.27.aspx - Perimenopause - Symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/perimenopause/symptoms-causes/syc-20354666#:~:text=The%20level%20of%20estrogen%20%E2%80%94%20the,release%20an%20egg%20(ovulate)
- Joyce T. Brombeger et al (2019) Depression During and After the Perimenopause: Impact of Hormones, Genetics, and Environmental Determinants of Disease. Obstet Gynecol Clin North Am. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6226029/
- Physical activity guidelines resources. ACSM_CMS.
https://www.acsm.org/education-resources/trending-topics-resources/physical-activity-guidelines#:~:text=All%20healthy%20adults%20aged%2018,on%20three%20days%20per%20week.