What is the role of hormonal changes in the etiology of mood disorders during menopause?

Updated: Jan 30, 2019
  • Author: Nita V Bhatt, MD, MPH; Chief Editor: Ana Hategan, MD, FRCPC  more...
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Observations and data suggest that depression is significantly linked to times of hormonal change in women. [29]  For example, the disparity in depression rates between women and men begins at puberty. Also, hormonal changes are thought to contribute to premenstrual dysphoric disorder, as well as mood changes post partum and in perimenopause. [30, 31]

Furthermore, estrogen affects both serotonin and norepinephrine, the 2 neurotransmitters thought to be most directly associated with depression. However, absolute levels of gonadal hormones are not correlated with depression. Estrogen and progesterone levels do not distinguish a woman with depression from one without depression.

When hormone concentrations were measured in perimenopausal or postmenopausal women with depression, no abnormal levels were found. [32] Rather, a certain subset of women seem to be predisposed to experience mood disturbances triggered by hormonal fluctuations. This subset includes women with a history of mood disorders or of premenstrual and postpartum mood-related symptoms.

The risk of depression appears to be higher during perimenopause, when hormone levels are changing, than during postmenopause, when estrogen and progesterone levels are low but stable. [27, 33, 8]

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