Depressed mood symptoms during the menopausal transition: observations from the Seattle Midlife Women's Health Study

To describe patterns of depressed mood during the menopausal transition (MT) and to investigate relationships between patterns of depressed mood and MT stages.

Women during MT and early postmenopause rated depressed mood from 0 to 4 in a 3-day diary. Variables were percentage days with zero ratings, days with ratings of 3 or 4, and slope of ratings over time. Cluster analysis was used.

Six distinct clusters were identified for 164 women. The three largest clusters (n = 134) had depressed mood ratings of zero (93% of days, 73%, 50%, respectively). Ratings of 3 or 4 were infrequent for these three clusters (0%, 3%, 9%, respectively). The three smallest clusters (n = 30) had zero ratings for 32% of days, 14% and 8%, respectively. The fourth cluster had 16% rated 3 or 4 with a positive slope. The fifth and sixth clusters had 23% and 6% of days at 3 or 4 with a negative slope. MT stage was not related to depressed mood ratings. Most women did not have depressed mood during the MT. Of those who did, some experienced improvement.

The majority of women for the majority of the time experienced MT without a high severity of depressed mood while a small group of women had mood worsening over time and others improved. Depressed mood that occurs during the MT should not be attributed automatically to menstrual cycle changes or normative changes. Instead, features of a woman's life that contribute to depression should also be considered.