When you think of menopause, you might think of hot flashes and night sweats. But many women also experience symptoms of depression. The risk of depression doubles or even quadruples during the menopausal transition, which has researchers looking for ways to address — or even prevent — the problem.
One study published in JAMA Psychiatry found that hormone therapy may help ward off symptoms of peri- and postmenopausal depression in some women. Researchers found that perimenopausal and early postmenopausal women who were treated with hormones were less likely to experience symptoms of depression than women in the study who were given a placebo.
But unfortunately, the findings present a far-from-perfect solution. Hormone therapy brings its own set of risks, and for this reason it likely shouldn’t be widely used for preventing depression in women at this stage of life, says Dr. Hadine Joffe, the Paula A. Johnson Associate Professor of Psychiatry in Women’s Health at Harvard Medical School, who wrote an editorial accompanying the study. “It’s not a ‘never,’ but it shouldn’t be a standard approach; in general, all of medicine has moved away from using hormones for prevention,” she says.
About the study
The study included 172 perimenopausal and early postmenopausal women ranging in age from 45 to 65 who were experiencing low-level symptoms of depression. Roughly half used a skin patch containing the hormone estradiol for 12 months, as well as intermittent oral progesterone pills. The rest received a fake skin patch and placebo pills.
The women were evaluated at the beginning of the trial and throughout for symptoms of depression, using the Center for Epidemiologic Studies Depression Scale. Researchers found that only 17% of women in the hormone group developed clinically significant depression, compared with 32% of those in the placebo group.
Untreated depression can cause physical symptoms, such as headaches and fatigue, in addition to emotional symptoms, including persistent sadness and even suicidal thoughts. It can interfere with daily function and reduce quality of life. However, hormone use brings its own health risks, such as a greater chance of blood clots and stroke. “It would be irresponsible to recommend this as a blanket prevention treatment for women,” says Dr. Joffe, who is also executive director of the Connors Center for Women’s Health and Gender Biology at Brigham and Women’s Hospital.
Despite the caveat about hormone therapy, the findings should not be ignored. Rather, the key message for women is that depression during perimenopause and early postmenopause should be taken seriously, and women at this stage of life should be more closely monitored for depressive symptoms. In addition, study authors identified at least one risk factor for depression that stood out among women in this group — recent life stress. “A lot of people have stress, so I think it’s an important message that stress contributes to depression,” says Dr. Joffe.
Depression symptoms are not a sign of someone’s failure to cope. “This really is a brain phenomenon,” says Dr. Joffe. So here are some action points based on the findings.
- Be aware of depression risk. Knowing that depression is more common during perimenopause and early postmenopause can help you identify worrisome symptoms and act quickly. If you are perimenopausal or in early postmenopause, your doctor should ideally be screening you for mood symptoms at your regular visits. If not, bring up the topic yourself. If symptoms do develop, ask your doctor for a referral to a mental health specialist.
- Weigh hormone therapy’s pros and cons. Hormone therapy may be the right choice for some women. Talk to your doctor about the potential benefits and risks. Consider how long to use hormone therapy and whether there are other medical reasons to consider taking it. Keep in mind that more research is needed to fully understand the potential benefits and drawbacks of using this therapy to prevent depression, says Dr. Joffe. Talk with your doctor about whether behavioral strategies or antidepressant drugs might be a good alternative choice for you.
- Consider lifestyle changes and treatment. Regardless of whether you opt for hormone therapy or not, nondrug strategies can also be used to reduce the likelihood of depressive symptoms, including managing stress and boosting physical activity.
Bible verses for today’s meditation and inspiration: Matthew E. McLaren
Your beauty should not come from outward adornment, such as elaborate hairstyles and the wearing of gold jewelry or fine clothes. Rather, it should be that of your inner self, the unfading beauty of a gentle and quiet spirit, which is of great worth in God’s sight. 1 Peter 3:3-4 NIV
Above all else, guard your heart, for everything you do flows from it. Proverbs 4:23 NIV
As water reflects the face, so one’s life reflects the heart. Proverbs 27:19 NIV
May he give you the desire of your heart and make all your plans succeed. Psalm 20:4 NIV
The heart is deceitful above all things and beyond cure. Who can understand it? “I the Lord search the heart and examine the mind, to reward each person according to their conduct, according to what their deeds deserve.” Jeremiah 17:9-10 NIV
You will seek me and find me when you seek me with all your heart. Jeremiah 29:13 NIV
Let love and faithfulness never leave you; bind them around your neck, write them on the tablet of your heart. Then you will win favor and a good name in the sight of God and man. Proverbs 3:3-4 NIV
Trust in the Lord with all your heart and lean not on your own understanding; in all your ways submit to him, and he will make your paths straight. Proverbs 3:5-6 | NIV
Create in me a pure heart, O God, and renew a steadfast spirit within me. Psalm 51:10 NIV
But the Lord said to Samuel, “Do not consider his appearance or his height, for I have rejected him. The Lord does not look at the things people look at. People look at the outward appearance, but the Lord looks at the heart.” 1 Samuel 16:7 NIV
Jesus replied: ‘Love the Lord your God with all your heart and with all your soul and with all your mind.’ Matthew 22:37 NIV
Take delight in the Lord, and he will give you the desires of your heart. Psalm 37:4 NIV
Each of you should give what you have decided in your heart to give, not reluctantly or under compulsion, for God loves a cheerful giver. 2 Corinthians 9:7 NIV
A cheerful heart is good medicine, but a crushed spirit dries up the bones. Proverbs 17:22 NIV
My son, do not forget my teaching, but keep my commands in your heart, for they will prolong your life many years and bring you peace and prosperity. Proverbs 3:1-2 NIV
The wise in heart accept commands, but a chattering fool comes to ruin. Proverbs 10:8 NIV
I seek you with all my heart; do not let me stray from your commands. Psalm 119:10 NIV
Be strong and take heart, all you who hope in the Lord. Psalm 31:24 NIV
Teach us to number our days, that we may gain a heart of wisdom. Psalm 90:12 NIV
I will praise you with an upright heart as I learn your righteous laws. Psalm 119:7 NIV
Blessed are those who keep his statutes and seek him with all their heart. Psalm 119:2 NIV
Truly I tell you, if anyone says to this mountain, ‘Go, throw yourself into the sea,’ and does not doubt in their heart but believes that what they say will happen, it will be done for them. Mark 11:23 NIV
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