Perimenopausal
Depression
by Claudio N Soares MD, PhD
The menopausal transition
has been associated with heightened prevalence and exacerbation of
underlying psychiatric illness, particularly depressive symptoms. It has
been speculated that sex steroids exert a significant modulation of
brain functioning, possibly through interactions with various
neurotransmitter systems. It is therefore intuitive that abrupt
alterations of these hormones would interfere with mood and behavior. On
the other hand, accumulating data suggest that hormonal interventions
may also promote relief or even remission of depressive symptoms.
This presentation will critically review recent data on
the complex relationships between sex hormones and mood during the
perimenopause. The prevalence and risk factors for recurrent /new onset
of depression during the perimenopause will be discussed, based on
recent findings derived from the epidemiologic, prospective
Harvard Study of Moods and Cycles.
Also, preliminary but promising data on the use of estrogens as an
antidepressant strategy (monotherapy or augmenting agent) for
perimenopausal and postmenopausal women with depression will be
reviewed.