Perimenopause and Menopause

In the United States more than 1.3 million women are expected to reach menopause every year. Menopause is reached when a woman has stopped menstruating for one full year. The transition to menopause, also known as perimenopause, represents the passage from a woman’s reproductive life to non-reproductive life. During perimenopause woman will experience irregular menstrual periods and may have hot flashes and night sweats, all of which reflect the large fluctuations in hormone levels during the transition. Women who are surgically menopausal (e.g. following removal of the ovaries), are at increased risk for depression compared to naturally menopausal women. During the menopausal transition, there is an increased risk for developing depression, even among women with no prior history. On the other hand, a history of depression increases the risk for an earlier menopausal transition. The dynamic interaction between depression and the perimenopause, including the roles of hormonal fluctuations, hot flashes, night sweats, and sleep disturbances, is an area of current research. While hormonal changes undoubtedly play a role in the development of mood symptoms, hormonal therapies are not necessarily the most appropriate treatments. Consideration must be given to standard psychiatric treatment modalities such as antidepressants and other medications.

Shari I. Lusskin, MD