Women with depressive symptoms preceding the final menstrual period are at greater risk of developing depression during the postmenopause, according to results from the Study of Womens Health Across the Nation (SWAN) recently published in the journal Menopause.¹

A total of 1551 middle-aged participants from the Study of Womens Health Across the Nation were included in the present study. A longitudinal analysis of the data on depressive symptoms gathered from 1996 to 2017 among the selected women was longitudinally analysed over 19 years (median) to examine depressive symptoms during postmenopause and the contribution of depressive symptom trajectories before the final menstrual period (FMP). The study also examined the impact of psychosocial/health factors on the postmenopause depressive symptoms.

Compared to premenopause stage, the probability of depressive symptom scores of 16 or higher on the Center for Epidemiologic Studies Depression Scale (CES-D) was greater during postmenopause with odds ratio of 1.49, but not during the menopausal transition or perimenopause. Based on the scores, three pre-final menstrual period groups were defined: “Group 1 (47.7%), consistently low scores, Group 2 (39.9%), moderate scores below the high depressive symptom threshold, and Group 3 (12.4%), consistently high scores”.¹ Women with moderate scores on the depression scale were nearly 3-folds more likely to have higher scores when postmenopausal with OR of 2.62, whereas women who scored high on the depression scale were at nearly 7-folds greater risk of higher scores during the postmenopause with OR of 6.88.

History of severe anxiety, sleep problems, vasomotor symptoms, low social support and childhood trauma/maltreatment before reaching the final menstrual period were also identified as contributing to higher odds of depressive symptoms during postmenopause.

Today is World Menopause Day and the theme for this year is “Cognition and Mood”. Hot flashes and night sweats are typically associated with menopause. However, the symptoms of menopause are wide-ranging. They include mood problems among several others. Earlier studies have shown that mood problems may adversely affect cognition. Hence, women approaching menopause should be regularly screened for risk factors predisposing to depressive symptoms later on and provided with appropriate treatment for a better quality of life.

Reference

1. Kravitz HM, et al. Risk of high depressive symptoms after the final menstrual period: the Study of Womens Health Across the Nation (SWAN). Menopause. 2022 Jul 1;29(7):805-815. doi: 10.1097/GME.0000000000001988.