Menopause and Depression

VERY EARLY MENOPAUSE – before the age of 40 – increases your risk of depression by about 45 per cent, according to new Canadian research.

In a study published in the journal Menopause in July, researchers from McMaster University in Hamilton surveyed more than 13,000 women aged 45 to 64 across the country, using a questionnaire that asked about loneliness, depression, hopefulness for the future and sleep.

Previous research shows that, in general, women are at greater risk for depression two to three years before their final period and in the early post-menopausal years. This is partly because of fluctuating, and then plummeting, estrogen hormones.

“Estrogen has antidepressant properties that affect brain chemicals such as serotonin – your happy chemicals,” says study leader Dr. Alison Shea, an obstetrician and gynecologist at St. Joseph’s Healthcare Hamilton and McMaster University.

The longer a woman’s brain is exposed to estrogen, either because of early menstruation or late menopause, the less likely she is to be depressed after menopause, says Shea.

While lack of estrogen can trigger depression, hormone replacement therapy is not necessarily the answer, she says. If it helps with hot flashes and sleep, it can certainly help boost a woman’s mood. But if she doesn’t experience these symptoms, HRT is unlikely to have an effect.

The average age of menopause is 51, but it can happen as early as your 20s and 30s, and often there is no clear explanation. But some causes are well known, such as cancer treatments, autoimmune diseases like multiple sclerosis or the surgical removal of the ovaries.

Shea’s study showed some factors make depression among older women less likely, whether or not they experience early menopause. These include higher education, higher income, being married or having a common-law partner, and having children.

Shea hopes her study will make women and family doctors more aware of menopause as a risk factor for depression and consider lifestyle changes, cognitive therapy or antidepressants. “I tell my patients it’s not a forever thing,” she says. “We just have to get you through this tough time.”