It is well known that women experience depression at higher rates than men. Some research suggests women are more prone to depression due to reproductive events, such as perinatal depression and premenstrual dysphoric disorder, which cause significant changes in hormones. Menopause, too, can increase the risk of depression because of significant hormonal changes. It is estimated that 26 to 33 percent of menopausal women experience depression.
The researchers used a 12-month placebo-controlled randomized trial to evaluate mood and cardiovascular benefits of estradiol in perimenopausal women. In the placebo group, fluctuations of estradiol were linked with a higher development of depressive symptoms as well as anger/irritability and feelings of rejection.
It’s important to note that changes in estradiol are not the same in all women. In women who did not experience a severe stressful event, depressive symptoms did not occur. Severe life stress was categorized by experiencing divorce or separation, serious illness of a close relative or friend, significant current financial issues, physical or sexual abuse or assault, significant arrest of self or loved one.
JoAnn Pinkerton, M.D., from The North American Menopause Society said, “These results provide tremendous insight for practitioners. Clinicians need to understand the impact of perimenopausal hormonal fluctuations and the degree of stressful events that a woman is experiencing to determine the best treatment options when a middle-aged woman complains of depression or exaggerated irritability. This study provides a foundation for future studies to evaluate the value of psycho-social interventions, such as cognitive therapies, to lessen the effect of major life events, as well as the use of estrogen therapy during perimenopausal and menopausal stressful times.”