Depression risk rises before menopause

A woman’s odds of developing depression for the first time increase greatly during perimenopause, a time of irregular periods and hormonal shifts before menopause, according to a landmark study.

Women who suffer from hot flashes are at particularly high risk for depression, shows the first research to follow a large group of women from before they enter perimenopause to menopause, checking how menstrual periods correlate with the first experience of depression.

Psychiatrist Lee Cohen, director of the Center for Women’s Mental Health at Massachusetts General Hospital, conducted the study.

The 591 women, most in their 40s, were premenopausal when the study began. As Cohen’s team followed them for up to five years, 365 of the women passed into perimenopause. These women were three times more likely than premenopausal women to develop the symptoms of major depression, Cohen says. About a quarter of them became depressed.

If women had bothersome hot flashes, they were six times more likely to be depressed.

Perimenopause can last four years or more and begins, on average, at the age of 47, Cohen says.

Conventional wisdom until a few years ago held that menopause — when periods have stopped for a year — left women depressed. New research is finding no evidence for that, Cohen says.

Most women sail through the transition without major mood swings.

But more research is needed to find out how many develop mental health problems during the shift into menopause and what might put women at high risk for such trouble.