Menopause and Depression

On this page:
Signs & symptoms
Risk factors
Treatment options
Print resources
Online resources

Everything seems to change as we get older, from family relationships to the faces we see in the mirror. And for women it all coincides with the physical passage of menopause. We've heard about it from our mothers and our friends, but until we go through it ourselves we can't be sure how menopause will affect our own lives. Each woman's experience is unique and personal: your best friend's story may be very different from yours. Getting to know yourself, your body, and your symptoms can help you to navigate this challenging path. Read on to find out things you should know and signs to look out for.

The hormonal changes that are at the core of menopause can trigger real depression in some women. If you do experience depression, it does not mean that you are weak or that you cannot cope. Your body is just responding in different way to the significant hormonal changes it is going through. Knowing the symptoms of depression and your risk factors for it can be your best first line of defense.

 

Signs and symptoms

Depression

• Sad mood
• Preoccupation with failures or inadequacies and a loss of self-esteem
• Feelings of uselessness, hopelessness, excessive guilt
• Slowed thinking, forgetfulness, difficulty in concentrating and in making decisions
• Loss of interest in work, hobbies, people
• Social isolation
• Lethargy
• Agitation/Irritability
• Changes in appetite or weight (eating too little or too much)
• Changes in sleep (sleeping too little or too much)
• Decreased sexual drive
• Suicidal thoughts

Menopause

You may experience some of the following temporary symptoms as you enter menopause:

• Irregular menstrual periods (closer together or farther apart)
• Achy joints
• Hot flashes
• Difficulty concentrating and remembering things
• Changes in sexual desire
• Extreme sweating
• Headaches
• Frequent urination
• Early wakening
• Vaginal dryness
• Mood changes
• Insomnia
• Night sweats
• Mood swings

General health care
Postmenopausal women can experience serious health problems (such as osteoporosis and heart disease) which are caused by the long-term effects of estrogen loss. It's important that women who are going through menopause take preventive measures, like eating healthy foods and getting regular exercise, to ensure their good health. Talk to your health care practitioner to find out what you can do to protect yourself.

 

Life changes

A woman's experience during menopause can also be influenced by other life changes, such as:

• Children leaving home
• Changes in domestic, social, and personal relationships
• Changes in identity and body image
• Divorce or widowhood
• Retirement
• Increased worry about illness, aging, and death
• Loss of friends, loved ones, and financial security
• Increased responsibility for aging parents
• Worry about loss of independence, disability, or loneliness

 

Definitions related to menopause

Menopause is the point at which a woman permanently stops menstruating. Natural menopause usually occurs between the ages of 41 and 55. A diagnosis of menopause is confirmed only after a full year has gone by without a menstrual bleed.

Perimenopause is the transitional phase, before menopause, when your menstrual periods may become irregular and symptoms (such as hot flashes) may begin. These symptoms are caused by declining estrogen production by the ovaries and may last anywhere from a few months to a few years.

Premature menopause is the term used when women go through menopause before age 40. Early onset of menopause may be the result of an autoimmune disorder or a thyroid problem.

Surgical menopause happens when a woman undergoes the surgical removal of her ovaries or has ovarian failure before she enters natural menopause. Ovarian failure may occur following removal of the uterus or after cancer therapy (chemotherapy or radiation).

Post menopause is the time period after a woman has not menstruated for 12 months.

 

Personal voices
"I think I was so busy with life that I never noticed all these changes creeping up on me. My family had moved apart, my body was doing some weird things and emotionally I felt so fragile. It really hit me one day when I went to my hairdresser and she pointed out that my hair was thinning. I had noticed other little changes here and there; an unfamiliar width around my middle, a desperate and frequent need to urinate, heavier but shorter periods, but I guess I just never put it all together. When I finally spoke with my doctor about it and she told me I was perimenopausal, it was kind of a relief. But, at the same time, it made me a bit sad. My body was taking the journey it was supposed to, I just never thought of myself as being there yet."
Jane, 44.

Risk factors for depression in menopause

A risk factor is something that increases your chances of having a certain illness or condition. It is not a guarantee or a life sentence. Many people have multiple risk factors but never experience the condition they were at risk for. However, knowing your risk factors can help you stay on top of your health and well-being.

The risk factors for developing depression during natural menopause include:

• History of depression
• History of premenstrual dysphoric disorder (PMDD)
• History of postpartum depression
• Lengthy perimenopause (with associated physical symptoms)
• Caretaking responsibilities (parent, partner or child)
• Loss of significant other
• Chronic health problems

The risk factors for developing depression during surgical menopause include:

• History of depression
• Young age
• Lack of social support
• Difficulties in personal relationships (e.g., divorce)
• History of multiple surgeries
• Surgery performed as an emergency

Treatment options

The treatment of depression triggered by menopause depends on how severe the symptoms are and whether someone has a previous history of depression. Treatment may include hormone replacement therapy, antidepressant medication and/or psychotherapy.

For a list of places where you can get treatment and/or find a doctor, click here.

If you aren't sure where to begin, you can learn more about your choices and figure out which treatments might be best for you. To learn more click here.

 

Print resources

1. Concise Guide to Women's Mental Health by Vivien K. Burt and Victoria C. Hendrick. American Psychiatric Publishing Inc., Second Edition, 2001.
2. Depression During the Transition to Menopause: A Guide for Patients and Families by D. Kahn, M. Moline, R. Ross, L. Altshuler and L. Cohen. From the MGH Centre for Women's Mental Health Web Site.
3. Menopause for Dummies by Marcia Jones and Theresa Eichenwald. Wiley Publishing Inc., 2003.
4. Role of Estrogen in the Treatment of Depression by S. Grigoriadis and S. Kennedy. American Journal of Therapeutics. 9(6):503-9, Nov-Dec. 2002.

 

Online resources

Centre for Research in Women's Health
www.crwh.org

MGH Centre for Women's Mental Health
www.womensmentalhealth.org

A Friend in Need
www.afriendindeed.ca

Women's Health Matters (keyword search: Menopause)
www.womenshealthmatters.ca

North American Menopause Society (NAMS)
www.menopause.org

Third Age  
www.thirdage.com/menopause

Planned Parenthood Federation of America
www.plannedparenthood.org

Menopause - The Journal of the North American Menopause Society - (Online Medical Journal)
www.menopausejournal.com

 

Sources

1. http://www.plannedparenthood.org/health-topics/womens-health/menopause-4807.htm

2. http://www.womensmentalhealth.org/specialty-clinics/menopausal-symptoms/