[Depression during the perimenopause]

Women are believed to be more vulnerable to depression during the perimenopause than during the premenopausal period. In clinical practice little attention has been given to the relationship between the menopause and depression.

To provide an overview of the literature on the relationship between the perimenopause and the development of depression and to analyse the relationship between hormonal fluctuations and depression.

We consulted the databases of PubMed, Web of Science and the Cochrane library, searching for epidemiologic studies on perimenopausal depression. We selected 22 studies relating to the prevalence of and the risk of depression during perimenopause.

Most of the 22 epidemiological studies selected suggest that the chances of developing depression during the perimenopause are higher than during during the premenopausal period. We found no unambiguous correlation between the fluctuation of hormones (e.g. oestrogen) and depression. A possible reason for this finding is that it is difficult to measure these hormones accurately.

The chances of developing depression seem to be higher during the perimenopause than during the premenopause. The difficulty in measuring the fluctuations of female hormones during the perimenopausal stage may be the reason why no correlation between depression and the fluctuations of hormones has yet been unambiguously established. Future studies and meta-analysis could provide a more accurate estimate of the risk of developing depression during the perimenopause and could give detailed information about the relationship between hormonal factors and perimenopausal depression.