Depression and Menopause

Taking a look at two recent papers

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There are a couple of new papers looking at menopause and depression that are worthy of discussion.

Depression and menopause is an important topic, but unfortunately, some of the data is contradictory, so the more information we can get, the better. The risk of depression in menopause (here I am using menopause to describe the whole experience from the menopause transition/premenopause to after the final period) varies significantly based on the study, but more and more data suggests those at highest risk are women with a previous history of depression.

Our ability to be more definitive about the risk of depression during menopause, the factors that increase that risk, and to understand the cause is hampered by the scarcity of long-term studies that have both adequately screened for depression as well as tracked the stage of menopause (technically known as the stage of reproductive aging, although I personally hate that term, because my God, I don’t exist for reproduction). For example, if researchers can’t accurately stage menopause, it might be challenging to separate an age-related change from a menopause-related change. Another issue is many studies use different measurements for depression, which can sometimes make comparisons difficult.

Another issue is many studies start in the early 40s, which may not be early enough to completely capture a depression arc linked with the menopause transition, which has an average age of onset of 45 years. This is where the first new study comes in. It was published this month (December 2024) in Menopause and is a 30-year longitudinal study about heart disease that also captured data about depression and menopause as well as information about demographics, lifestyle, medications, and medical conditions. Women were enrolled between ages 23 and 30, so this study could catch women before they entered the menopause transition.

In this study, women were screened for depression at year five and then every five years until age 60. Menopause status was obtained by questionnaire, possibly making