Oestrogen appears to have a protective effect against a low mood. A growing body of research suggests that when it drops in the lead-up to menopause and beyond, that plummet may also lower levels of serotonin – known as the happiness hormone – and dopamine, also called the pleasure hormone.
“This may partly explain why women who have never suffered from depression before are two to four times more likely to experience depression at perimenopause,” Thew says.“This hormonally linked depression may be mild and cause general feelings of sadness or it may be crushing, leaving women feeling hopeless or despairing.”
As hormone levels in a woman’s brain can start to shift (even before obvious signs such as hot flushes or erratic periods commence) some GPs may not make the connection between menopausal changes and feelings of depression.
“In our clinic we see many women who have tried everything from antidepressants and cognitive behavioural therapy to mindfulness and meditation and their depression is just not lifting, because the hormonal changes driving the depression are not being addressed,” Thew explains.
“As a general rule, higher levels of oestrogen cause an increase in mood so when they rise then fall during midlife, women may experience mood swings. Progesterone levels start to also lower, so a sudden spike may then cause irritation and grumpiness in some women.”