Researchers at Brigham and Women’s Hospital (BWH) have found that a lifetime history of depression may be significantly associated with an early decline in ovarian function. Women in their late 30s and early 40s experiencing depressive symptoms and currently on medication to treat their mood disorders appear to be at the greatest risk of starting perimenopause at a younger age. These new findings are documented in an article published in the Jan. 13 issue of the Archives of General Psychiatry.
Among 976 study participants selected from the general population and followed for three years, a greater proportion of women with a history of depression reached perimenopause sooner than women with no depression history. The research team, which included colleagues at the Massachusetts General Hospital (MGH), concluded that a woman’s chances of transitioning to perimenopause at an earlier age appeared to be contingent on the severity of her depression and her medication use.
The subgroup of women who were experiencing depressive symptoms at the time of study enrollment were twice as likely to go through perimenopause at a younger age compared with women with no lifetime history of depression, and those experiencing depressive symptoms at study enrollment who were also on antidepressants were nearly three times more likely to reach an earlier onset of perimenopause.
According to the World Health Organization, perimenopausal transition is defined as the time immediately preceding menopause when the ovaries gradually begin to produce less estrogen. During this time, which typically begins during the fourth decade of life, women begin to experience changes in their usual menstrual cycle characteristics and may also begin to experience early menopausal symptoms such as hot flashes and sweats.
Depression, twice as common in women as men, affects approximately 7 million women in the United States. Given the higher risk of depression among women and the fact that menopause is a time of marked mood swings, Harlow and his co-authors were particularly interested in examining how the two conditions may interplay. Their data revealed a relationship between earlier menopause and depression – one that may have important public health implications.
“We found that the association between depression and an earlier transition to perimenopause may result in prolonged exposure to low estrogen levels. This state is associated with greater bone density loss, sexual dysfunction, a decline in cognitive function, and increased risk of heart disease,” said Harlow, also of BWH.
“Our research may encourage more screening for depression symptoms and history by gynecologists,” Harlow said. “Similarly, psychiatrists may also focus more attention on menstrual cycle changes and perimenopausal symptoms while screening late-reproductive-aged patients with recurrent mood disorder.”