Risk of depression rises with approach of menopause: studies
— Two separate studies show a woman's risk for a first bout with depression
rises sharply as she approaches menopause.
One of the studies measured hormone levels in 231 Philadelphia-area women
over eight years and found that a woman's chances of tumbling into depression
grew as her hormones changed.
The message for women at mid-life?
“It's not all in your head,” said Ellen Freeman of the University of
Pennsylvania School of Medicine and a co-author of the Philadelphia study.
Most women reach menopause without suffering depression, but both new studies
suggest that some may be more sensitive to the transition.
“There is a subgroup of women who, for multiple reasons, may be more
vulnerable,” said Dr. Lee Cohen of Harvard Medical School, a co-author of the
second study, which followed 460 Boston-area women for six years.
The Philadelphia study found that women with a history of premenstrual
syndrome, or PMS, were more likely to experience depression when they neared
Dr. Cohen said women and their doctors shouldn't discount a disabling
depression during the transition from normal menstrual cycles to the time when a
woman's periods cease.
“Those who develop depression really need to be treated” with talk
therapy, antidepressants or both, he said. Hormone therapy may be helpful to
some women, he said.
The federally funded studies, published in the April issue of Archives of
General Psychiatry, looked only at women with no prior history of depression.
The women were in their 30s and 40s when the studies began.
Dr. Cohen and one of his co-authors noted in their paper that they have
financial ties to several antidepressant manufacturers.
The Boston study found women nearing menopause were nearly twice as likely to
develop symptoms of depression as women who hadn't yet experienced changes in
their menstrual cycles. The Philadelphia study found that women who reported
depressive symptoms were five times more likely to be nearing menopause.
Some medical experts have speculated that such depression may stem from sleep
disruption caused by hot flashes. But both new studies found depression to be
independent of that.
Still, in the Harvard study, the women most likely to get depressed were
those who had both hot flashes and more stressful events in their lives, such as
a family death or a divorce, noted Nancy Fugate Woods, nursing school dean at
the University of Washington.
“It isn't possible, in the reality of women's lives, to tease those things
apart completely,” said Woods, who has done similar research, but was not
involved with the new studies. “No matter how clever the research design is,
you're still stuck with human beings.”