Perimenopause, defined as the time period immediately prior to menopause beginning with normal, biological, and clinical changes and ending a year after the last menstrual periods, is a time of increased vulnerability to depression, especially for women with a history of mood disorders. Earlier studies have shown that women who experienced menopause before 47 years of age (considered early) were two to three times more likely to have had depression that was treated with medication for one year or longer compared to women who made a normal transition to menopause (around age 50).
The new research study included 330 women with and 646 women without a history of major depression between the ages of 36 and 45 years old. None of the women enrolled in the study had gone through menopause yet. Psychiatric interviews and reproductive histories and early follicular-phase blood specimens were taken at the beginning of the study, and every six months for the 36 months of follow up. The researchers determined the beginning of menopause, or perimenopause, by a follow up interview indicating a seven day or more change in menstrual cycle length, a change in menstrual flow amount or duration, and cessation of menstruation for at least three months.
The study revealed that women with with a history of depression had 1.2 times the rate of perimenopause than women with no history of depression. Women who showed more pronounced depressive symptoms at the beginning of the study had twice the risk of an earlier perimenopause and those women who took antidepressants had thrice the risk of an earlier perimenopause as compared to non-depressed women.
The study gains significance as an earlier transition to perimenopause may result in a prolonged exposure to a hypoestrogenic (estrogen deficiency) state, which has been associated with bone density loss, sexual dysfunction, a decline in cognitive function, and a potential increased risk of cardiovascular disease.