Menopause and Depression Risk: Why It Rises in Perimenopause
Menopause is a significant life transition that can bring not only physical changes like hot flashes and sleep disturbances, but also emotional challenges. Many women approaching menopause find themselves facing mood swings or feelings of sadness that can be difficult to understand. Dr. David Danish and Dorota Ketch, PMHNP, recognize how tough this phase can be for patients. That’s why they stay at the forefront of research on women’s mental health during menopause, continually updating their knowledge and incorporating new findings into patient care. Their patient-centric, integrative approach means they’re always looking for the best ways to support women through menopause-related mood changes.
A recent scientific study has shed new light on the link between menopause and depression, and it’s particularly relevant to their practice. This systematic review and meta-analysis focused on the risk of developing depression at different stages of menopause. In other words, it looked at how likely women are to experience depressive symptoms before menopause (premenopause), during the menopausal transition (perimenopause), and after menopause (postmenopause). The findings are clinically important because they help identify when women might be most vulnerable to depression. Understanding these patterns allows Dorota Ketch, CRNP, and Dr. Danish to screen and support patients proactively during the stages when they need it most.
How Menopause Affects Depression Risk
Why Perimenopause Increases Depression Risk
One of the key findings of the study is that women are significantly more likely to develop depression during perimenopause than during the premenopausal stage. In fact, the analysis showed about a 40% increased risk of depressive symptoms or a diagnosis of depression for perimenopausal women compared to women who haven’t yet reached menopause. Perimenopause is the transition period leading up to menopause, when hormone levels (especially estrogen) start fluctuating greatly. These hormonal fluctuations are believed to play a major role in mood changes. Estrogen, for example, influences neurotransmitters like serotonin and dopamine, which regulate mood. When estrogen levels swing up and down, it can destabilize these brain chemicals, potentially triggering feelings of depression or anxiety.
But biology isn’t the only factor. Perimenopause often coincides with midlife stresses that can affect mental health. Women in this stage may be juggling many responsibilities—career changes, caring for aging parents, children leaving home, or other life transitions. It’s not surprising that the combination of hormonal upheaval and psychosocial stress can make one more susceptible to depression. As one expert put it, new onset depression around perimenopause is likely related to “both these brain neuronal changes and life stresses” happening at the same time. In short, perimenopause can create a perfect storm for mood difficulties: your body’s chemistry is in flux and life might be throwing extra challenges your way. Dorota Ketch, CRNP, understands this interplay and takes both factors into account when treating patients.
It’s worth noting that the study backing these findings was quite robust. The researchers pulled together data from over 16,000 women across 17 high-quality studies around the world. By combining results from so many participants, they could see clear patterns that smaller studies might miss. They used rigorous methods to ensure the results were reliable – for example, all the studies were prospective (following women over time) and they assessed the quality of each study to minimize bias. This gives us confidence that the 40% higher risk in perimenopause is a real effect, not a fluke. It highlights that the menopausal transition is a critical period for women’s mental health.
Depression Risk After Menopause: A Return to Baseline
Another reassuring finding from the meta-analysis is that postmenopausal women did not show a significantly higher risk of depression compared to premenopausal women. In other words, once a woman transitions through menopause and enters postmenopause, her overall risk of developing depression seems to level off, becoming similar to women who haven’t gone through menopause. This suggests that it’s the turbulent transition years (perimenopause) that are the most vulnerable time for new depression, rather than menopause itself causing an ongoing increase in risk.
Why might this be the case? One theory is that after menopause, hormone levels (like estrogen and progesterone) settle at a consistently low level, and the body adapts to this new normal. The absence of drastic hormonal swings may mean fewer mood disruptions directly caused by biology. Some women even report feeling more emotionally stable after menopause than during the years leading up to it. Of course, women can still experience depression in later life, but the good news from this study is that simply being postmenopausal doesn’t automatically put someone at higher risk for depression. Many postmenopausal women thrive emotionally; the critical message is that the menopausal transition (perimenopause) is the time to be especially watchful.
What This Means for Women’s Mental Health
This research has a clear takeaway: women in their late 30s to 40s who are approaching menopause should be proactive about mental health. If you are entering perimenopause (or think you might be), it’s wise to be aware of the heightened risk for depression during this phase. Early detection is key. Dorota Ketch, CRNP, emphasizes the importance of routine screening for depressive symptoms when women are in their 40s and 50s and starting to notice menopausal changes.
Getting in Touch with Dr. Danish and Dorota Ketch, PMHNP
If you’re going through menopause or perimenopause and notice mood changes, Dorota Ketch, PMHNP, and Dr. Danish at Philadelphia Integrative Psychiatry are here to help. As specialists who understand the unique interplay between hormonal changes and mental health, they offer comprehensive evaluations to get to the root of what you’re experiencing.
(To schedule an appointment or learn more, you can visit Philadelphia Integrative Psychiatry or call their office.)
For More on This Topic and Related Subjects, Check Out These Blogs by Dr. Danish:
https://phillyintegrative.com/blog/how-menopause-disrupts-sleep-and-what-you-can-do-about-it
