Menopause Depression

“Hormonal changes around the time of menopause
can lead to anxiety and depression,
but other factors may also cause these feelings”.1

Umbrella

What may the Menopause Depression umbrella include?

Depending on the Source (DotS) this Umbrella may include:

  • Clinical Depression
  • Depression
  • Depressive Disorder
  • Major Depression
  • Major Depressive Disorder
  • Menopause Blues

Depression

What is depression?

DotS the definition of depression may vary. In Depressive Disorder (Depression): Overview, 31 March 2023, the World Health Organization’s definition is:

“Depressive disorder (also known as depression) is a common mental disorder. It involves a depressed mood or loss of pleasure or interest in activities for long periods of time.

Depression is different from regular mood changes and feelings about everyday life. It can affect all aspects of life, including relationships with family, friends and community. It can result from or lead to problems at school and at work”.2

In Depression: What Is Depression? last reviewed March 2024, the (United States) National Institute of Mental Health’s (NIMH) definition is:

“Depression (also known as major depression, major depressive disorder, or clinical depression) is a common but serious mood disorder. It causes severe symptoms that affect how a person feels, thinks, and handles daily activities, such as sleeping, eating, or working.

To be diagnosed with depression, the symptoms must be present for at least 2 weeks”.3

Sadness or Depression

Is sadness the same as depression?

In Depression In Women: 4 Things To Know the NIMH explain:

“Feeling sad is a normal reaction to difficult times in life. Depression is different—it is a mood disorder that can affect how a person feels, thinks, and acts”.4

Perimenopause

Is there an association between perimenopause and depression?

In Depression In Women: 4 Things To Know – 3. Certain Types of Depression Are Unique To Women the NIMH note:

  • “Perimenopausal Depression affects some women during the transition to menopause. Whereas abnormal periods, problems sleeping, mood swings, and hot flashes are common during the menopause transition, more extreme feelings of irritability, anxiety, sadness, or loss of enjoyment may be signs of depression”.5

Menopause

Is there an association between menopause and depression?

In Menopause Depression: Women, Menopause and Depression HER Center Australia elaborate on:

Menopause Depression“Depression in women in their mid-40’s to early 50’s is a significant problem. For women, middle age is the age with a very high risk of both first time depression as well as depression recurrence. Related to this is the tragic statistic that women aged 45-49, have a high completed suicide rate. The impact of menopause is a critical factor in the development of depression in this group, be it for the first time, or a recurrence of previous depression.

While many women do not experience significant mental ill health during the transition to menopause, an estimated 40% of perimenopausal women present to their primary healthcare physicians with depressive symptoms. Importantly, depressive symptoms experienced in the menopause transition are different and often worse in severity compared to depression in younger and older women”.6

In Menopause and Mental Health: Mental Health Symptoms Related To Menopause, content updated February 2023, the Australasian Menopause Society (AMS) elaborate on:

“Mental health symptoms related to menopause can include feeling:

  • Irritable
  • Sad
  • Anxious
  • Hopeless
  • Less able to concentrate or focus
  • Tired
  • Unmotivated

Some women might experience these symptoms in a mild form. Others might have more severe symptoms of depression (including thoughts of suicide) lasting for at least two weeks. This is known as a major depressive episode and is more likely in women who have a history of major depression during their pre-menopausal years.

While many women do not have mental health issues during the menopausal transition, unstable oestrogen levels can have an impact on the brain, predisposing some women to feelings of depression and anxiety”.7

Cause

What may cause depression during menopause?

On page 777 in The 2022 Hormone Therapy Position Statement of The North American Menopause Society: Depression, published July 2022, the North American Menopause Society note:

“Depressive symptoms worsen as women transition through menopause, although evidence is mixed as to whether depressive disorders are more common during the menopause transition relative to premenopause. Most women who present with depressive disorders during the menopause transition are women with a history of depression before the menopause transition, and women with a history of depression are at high risk for recurrence during the menopause transition”.8

In Managing Your Symptoms: Managing Mood and Emotional Health – Anxiety and Depression the (Australian) Jean Hailes for Women’s Health explain:

“Hormonal changes around the time of menopause can lead to anxiety and depression, but other factors may also cause these feelings.

If you experienced anxiety before reaching menopause, some symptoms could make your anxiety worse. For example, hot flushes could lead to an anxiety attack.

Also, symptoms such as night sweats can affect your mood and make you feel exhausted, grumpy or depressed.

At this stage of life, you may experience depression for different reasons. For example, if you are having relationship problems or feeling more stress than normal.

You might also reflect on negative past experiences during this time, leading to feelings of depression”.9

In Mood and the Menopause, content updated 09 February 2023, the AMS elaborate on:

“Risk factors for depressive symptoms/disorders are multiple and include VMS, previous mood disorders including prior MDD, reproductive related mood disturbance (severe premenstrual syndrome (PMS) or postpartum depression), other health factors, psychological and socioeconomic factors, and hormonal changes such as variability in FSH and oestradiol”.10

What is VMS?

VMS can be an abbreviation for Vasomotor Symptoms such as hot flushes and night sweats.

What is MDD?

MDD can be an abbreviation for Major Depressive Disorder.

What is FSH?

FSH can be an abbreviation for Follicle Stimulating Hormone.

Treatment

How may perimenopausal and menopausal depression be treated?

In Menopause and Mental Health: Treatment Options for Mental Health Symptoms the AMS elaborate on:

“Women should have an individualised assessment with their doctor in order to discuss the most appropriate treatment pathway. Options may include lifestyle changes, psychological therapies and medications such as menopausal hormone therapy (MHT) or antidepressants.

While some international guidelines do not recommend MHT as first line therapy, many doctors have seen a positive effect on mood with the use of MHT in the first instance. There is evidence that oestrogen has antidepressant effects, particularly in perimenopausal women. We emphasise an individualised approach with treatment tailored to the individual patient.

Oestrogen is not recommended for women with a history of breast cancer.

At this stage, there is no evidence to recommend alternative or complementary therapies for treatment of perimenopausal depression”.11

Hormone Therapy vs Antidepressants

What does Professor Kulkarni explain about hormone therapy or menopausal hormone therapy (MHT) as a  treatment option for menopause mental health issues?

In Depression: A Major Challenge of the Menopause Transition – Abstract, published October 2022, Professor Kulkarni, Professor of Psychiatry at The Alfred Hospital, Melbourne; Head of Department of Psychiatry at Monash University, Melbourne; and Director of the Monash Alfred Psychiatry Research Centre, Melbourne, Victoria, explains:

“Guidelines recommend antidepressant medications as first-line treatment; however, emerging evidence suggests menopausal hormone treatment may also be effective. A biopsychosocial approach to management, including treating depressive symptoms and addressing relevant psychological and lifestyle factors, offers the best outcomes and improvement in quality of life”.12

In Menopause Depression: Under Recognised and Poorly Treated – A New Approach for Menopausal Mental Health, published 18 May 2024, Kulkarni, J. et al. also elaborate on:

“MHT is an important part of the treatment options available for menopausal mental health issues, particularly in the early perimenopause timeframe. The newer forms of MHT given in safer delivery modes potentially offer better outcomes for menopausal mental health and physical health issues. Coupled with comprehensive baseline and follow-up investigations, MHT may provide better resolution of menopausal depression, anxiety and ‘brain fog’ than current psychiatric medications that provide partial relief but have many side effects…”.13

Health Care Provider

What if I feel depressed?

If you feel depressed, it may be in your best interest to choose to talk to your health care provider abut this, soon as possible.

In Menopause and Mental Health: Untangling Physical and Mental Health Symptoms Related To Menopause the AMS elaborate on:

“Speaking with your doctor about your menopausal symptoms, life circumstances and clinical history can help them to recommend the best treatment options and lifestyle and behavioural changes for your situation”.14

In Menopause and Mind Health the JH remind us:

“Everyone experiences menopause differently. Talk to your doctor if:

  • You are experiencing strong emotions
  • You think you have anxiety or depression
  • Menopausal symptoms are impacting your quality of life
  • Your brain fog is long lasting or stopping you from doing daily activities”.15

In Menopause Depression: Under Recognised and Poorly Treated – A New Approach for Menopausal Mental Health, Kulkarni, J. et al. note:

“As with other mental health areas, the person with lived experience must be a key driver and collaborator in determining what treatment approaches she wants. In the area of menopausal mental health, the woman experiencing hormone-created anxiety, depression, cognitive changes (known as ‘brain fog’) and physical health issues related to menopause needs to decide what her individualised care programme includes, based on well-informed options”.16

Health Topics A-Z

Where may I find Health Topics A-Z related to Menopause Depression?

In Health Topics A-Z you may find:

Health Topics A-Z

Links

Where may I find Links related to Menopause Depression?

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Links

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New or Updated

  1. 20 Ways To Relieve Stress
  2. Anxiety Self-Help Guide
  3. Anxiety vs. Depression: Which Do I Have (or Is It Both)?
  4. Askearlymenopause.org [Ask EM] [+ Video: What Is Early Menopause?]
  5. Boost Your Mood With Mind-Nourishing Food
  6. Can Menopause Cause Depression?
  7. Cognitive Behaviour Therapy (CBT) for Menopausal Symptoms
  8. Common Mental Health Diagnoses Arising From or Coinciding With Menopausal Transition and Prescribing of SSRIs/SNRIs Medications and Other Psychotropic Medications
  9. Consumer Video and Podcast Series: 2023 Consumer Videos and Podcasts – NAMS 2023 Nonhormone Therapies Position Statement for Bothersome Menopause Symptoms
  10. Consumer Video and Podcast Series: 2024 Consumer Videos and Podcasts – Preparing for Your Menopause Healthcare Visit
  11. Depression
  12. Depression
  13. Depression in Women: 4 Things To Know
  14. Depression [+ Video Courtesy: Mayo Clinic News Network]
  15. Depression and the Menopause
  16. Depression: A Major Challenge of the Menopause Transition
  17. Do You Know Someone Who May Be Considering Suicide
  18. Does Menopause Hormone Therapy Improve Symptoms of Depression? Findings From A Specialized Menopause Clinic
  19. Does Menopause Really Cause Depression?
  20. Effects of Nutritional Interventions on the Severity of Depressive and Anxiety Symptoms of Women In the Menopausal Transition and Menopause: A Systematic Review, Meta-Analysis, and Meta-Regression
  21. Emotional Well Being
  22. Emotional Wellness In Menopause
  23. Exercise for the Treatment of Depression
  24. Exercising Your Way Out of Depression
  25. Facebook Live Event: The Menopause Transition and Depression
  26. Find A Menopause Practitioner [United States and Other]
  27. Find An AMS Doctor [Australasian Menopause Society i.e. Australia and New Zealand]
  28. Find Your Nearest BMS Menopause Specialist [British Menopause Society]
  29. Finding A Mental Health Professional
  30. Getting Help [United Kingdom]
  31. Headtohealth.gov.au: Head To Health [Australia]
  32. HER Centre Australia
  33. How To Manage Menopausal Insomnia
  34. How To Talk To Your Doctor About Midlife Brain Fog
  35. I Forgot To Ask the Doctor – E17: Are Anxiety & Depression Destroying Your Life?
  36. Is Hormone Therapy A Key Strategy In Treating Menopausal Depression? [Video]
  37. Jayashri Kulkarni: Our Hormones and Our Minds [Podcast]
  38. Joint BMS FSRH RCGP RCOG SfE and RCN Women’s Health Forum Safety Alert
  39. Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause
  40. Later Years (Around 50 Years and Over): Menopause and Post Menopause Health – Menopause and Your Mental Wellbeing [+ Video: Menopause Only Affects You Physically!] [Other Languages and Formats]
  41. Later Years (Around 50 Years and Over): Menopause and Post Menopause Health – Signs and Symptoms of Menopause [+ Video: Talking Menopause With Your GP] [Other Languages and Formats]
  42. Later Years (Around 50 Years and Over): Menopause and Post Menopause Health – Supporting Someone Through the Menopause [+ Video: Men Don’t Need To Know About Menopause] [Other Languages and Formats]
  43. Let’s Talk About Perimenopause
  44. Mastering Midlife Mood Changes With Marlene Freeman, MD
  45. Mayo Clinic Q and A: Emotional Exhaustion: When Your Feelings Feel Overwhelming
  46. Mayo Clinic Q and A: Perimenopause Transitions and Concerns
  47. Menopause
  48. Menopause Depression
  49. Menopause Depression Risk Has Been Exaggerated
  50. Menopause Depression: Under Recognised and Poorly Treated [Kulkarni, J. et al]
  51. Menopause Depression: Under Recognized and Poorly Treated [By Professor Jayashri Kulkarni and Dr Louise Newson, on behalf of all authors on article]
  52. Menopause Map: Downloadable Resources – My Personal Path Print Tools: Questions for Your Health Care Provider
    Menopause Depression
  53. Menopause Map: Downloadable Resources – My Personal Path Print Tools: Symptom Tracker
    Menopause Depression
  54. Menopause Patient Information [Videos] 2. Talking To Your GP About Menopause
  55. Menopause Patient Information [Videos] 5. Lifestyle Advice In Menopause & Perimenopause
  56. Menopause Preparedness Toolkit: A Woman’s Empowerment Guide
  57. Menopause Transition Does Not Increase Risk for Depressive Symptoms for All Women
  58. Menopause and Mental Health
  59. Menopause and Mental Health
  60. Menopause and Mental Health
  61. Menopause and Mind Health
  62. Menopause and Your Mental Wellbeing
  63. Menopause: Things You Can Do
  64. Menopause: Understanding the Changes and Finding Relief | Dr Susan Davis | The Proof Podcast EP 256
  65. Menopause Depression
    Mental Health: Mental Health Self Help Guides
  66. Mood Changes During Perimenopause Are Real. Here’s What to Know.
  67. Mood and the Menopause
  68. Mymenoplan.org [My Menoplan, United States]
  69. National Center for Complementary and Integrative Health: Depression
  70. National Center for Complementary and Integrative Health: Herbs At A Glance
  71. National Center for Complementary and Integrative Health: How Safe Is This Product or Practice?
  72. National Institute of Mental Health: Depression
  73. Navigating Menopause: Expert Insights and Solutions | Dr Susan Davis | The Proof Podcast EP 245
  74. Navigating Menopause: Could Better Support Reduce Depression Risk?
  75. Navigating Menopause: Honest Answers To All Your Questions [+ Video: What To Expect in Menopause]
  76. “Not feeling like myself” in perimenopause — what does it mean? Observations From the Women Living Better Survey
  77. Perimenopause
  78. Perimenopause
  79. Perimenopause and Depression
  80. Perimenopause and Menopause Checklist: Translated Checklists
  81. Perimenopause and Menopause Symptom Checklist
  82. Promoting Good Mental Health Over the Menopause Transition
  83. Self-Help Tool: Menopause and Mental Wellbeing
  84. Severe Mental Illness and the Perimenopause
  85. Supporting A Loved One Through Menopause
  86. The Menopause Society Statement on Misinformation Surrounding Hormone Therapy
    Hormone Therapy
  87. The Risk of Depression In the Menopausal Stages: A Systematic Review and Meta-Analysis
  88. The Truth About Menopause Supplements | Dr Sarah Berry
  89. Therapy Could Be Effective Treatment for Non-Physical Symptoms of Menopause
  90. Tips To Help Manage Menopause Symptoms
  91. Top Tips To Improve Your Mental Wellbeing
  92. Using Network Analysis To Understand the Association Between Menopause and Depressive Symptoms
  93. Videos and Podcasts: Videos – Interviews: A Simple Approach To Menopause: The Menopause Quick Six (www.MQ6.ca)
  94. Webinars: Previous – Non-Hormonal Pharmacological Interventions For VMS
  95. Webinars: Previous – Non-Pharmacological Interventions For VMS
  96. What Everyone Should Know About Menopause Symptoms
  97. What Is Cognitive Behavioral Therapy?
  98. Women and Mental Health
  99. World Menopause Day: Leaflet for Women
  100. World Menopause Day: Poster for Women

Sources

Where may I find the Sources quoted?

You may find the Sources quoted at:

Sources

  1. Managing Your Symptoms: Managing Mood and Emotional Health – Anxiety and Depression. Last Updated: 19 December 2023 | Last Reviewed: 19 August 2022. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/menopause/managing-your-symptoms#managing-mood-and-emotional-health Accessed: 10 September 2024
  2. Depressive Disorder (Depression): Overview. 31 March 2023. World Health Organization https://www.who.int/news-room/fact-sheets/detail/depression Accessed: 10 September 2024
  3. Depression: What Is Depression? Last Reviewed: March 2024. National Institute of Mental Health https://www.nimh.nih.gov/health/topics/depression/index.shtml#part_145398 Accessed: 10 September 2024
  4. Depression In Women: 4 Things To Know. Revised: 2023. National Institute of Mental Health https://www.nimh.nih.gov/health/publications/depression-in-women Accessed: 10 September 2024
  5. Depression In Women: 4 Things To Know – 3. Certain Types of Depression Are Unique To Women. Revised: 2023. National Institute of Mental Health https://www.nimh.nih.gov/health/publications/depression-in-women Accessed: 10 September 2024
  6. Menopause Depression: Women, Menopause and Depression. HER Center Australia https://www.monash.edu/medicine/her-centre/education/resources/menopause-depression Accessed: 10 September 2024
  7. Menopause and Mental Health: Mental Health Symptoms Related To Menopause. Content Updated: February 2023. Australasian Menopause Society https://www.menopause.org.au/health-info/fact-sheets/menopause-and-mental-health Accessed: 10 September 2024
  8. The 2022 Hormone Therapy Position Statement of The North American Menopause Society: Depression. Menopause: The Journal of the North American Menopause Society Vol: 29, No. 7, pp 767-794. North American Menopause Society https://www.menopause.org/docs/default-source/professional/nams-2022-hormone-therapy-position-statement.pdf Accessed: 10 September 2024
  9. Managing Your Symptoms: Managing Mood and Emotional Health – Anxiety and Depression. Last Updated: 19 December 2023 | Last Reviewed: 19 August 2022. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/menopause/managing-your-symptoms#managing-mood-and-emotional-health Accessed: 10 September 2024
  10. Mood and the Menopause. Content Updated: 09 February 2023. Australasian Menopause Society https://www.menopause.org.au/hp/information-sheets/mood-and-the-menopause Accessed: 10 September 2024
  11. Menopause and Mental Health: Treatment Options for Mental Health Symptoms. Content Updated February 2023. Australasian Menopause Society https://www.menopause.org.au/health-info/fact-sheets/menopause-and-mental-health Accessed: 10 September 2024
  12. Kulkarni, J. et al. Depression: A Major Challenge of the Menopause Transition – Abstract. October 2022 https://medicinetoday.com.au/mt/2022/october/feature-article/depression-major-challenge-menopause-transition Accessed: 10 September 2024
  13. Kulkarni, J. et al. Menopause Depression: Under Recognised and Poorly Treated – A New Approach for Menopausal Mental Health. 18 May 2024 https://journals.sagepub.com/doi/10.1177/00048674241253944 Accessed: 10 September 2024
  14. Menopause and Mental Health: Untangling Physical and Mental Health Symptoms Related To Menopause. Content Updated: February 2023. Australasian Menopause Society https://www.menopause.org.au/health-info/fact-sheets/menopause-and-mental-health Accessed: 10 September 2024
  15. Menopause and Mind Health: When To See Your Doctor. Updated: May 2023. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/resources/menopause-and-mind-health Accessed: 10 September 2024
  16. Kulkarni, J. et al. Menopause Depression: Under Recognised and Poorly Treated – A New Approach for Menopausal Mental Health. 18 May 2024 https://journals.sagepub.com/doi/10.1177/00048674241253944 Accessed: 10 September 2024
Topic Last Updated: 24 November 2024 – Topic Last Reviewed: 10 September 2024

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