Perimenopause may trigger the first episode of depression.  Women in their late 40s are often in this hormonal stage called “perimenopause.” This is when the body may still have a menstrual period, but that the menstrual cycles are irregular because their estrogen is waning.  Perimenopause can cause nearly a decade of hormonal instability.

Women are at increased risk of developing depression during this perimenopausal transition.  In fact, studies have shown that 45 – 68% of perimenopausal women have elevated depression symptoms.

Other risk factors that increase the risk of perimenopausal depression include

• psychosocial changes like adverse life events,
• anxiety,
• low social support,
• interrupted sleep,
• black race, and
• financial difficulties.

Perimenopause is often a time of great transition: caring for aging parents, launching their adult children into life, or facing changes in marital status.  Your physician may perform a Patient Health Questionnaire-9 (PHQ-9) to help diagnose a mood disorder or may perform a test to show life scales with mood items like the Menopause Rating Scale and the Menopause-Specific Quality of Life Scale.

Some suggestions are psychotherapy, exercise, medication to help with mood changes (like SSRIs).  Botanical and or complementary/alternative approaches for treating menopausal depression have not statistically been shown to help.  Whatever treatment works for you is the best treatment.  See your physician for help.

https://www.mdcalc.com/phq-9-patient-health-questionnaire-9