What are the causes of depression during the menopause transition?

Many studies suggest that women have more feelings of being sad and blue as well as more changes in mood during the menopause transition, but only a few studies show more depression that requires treatment. Depression is more likely if the transition is prolonged (greater than 27 months) with more symptoms or stressors. There are many theories about why some women may find themselves more moody during the menopause transition:Estrogen affects neuronal function, so it is possible that falling levels of estrogen during the perimenopause affect mood.

Hormones have been shown to increase endorphins; therefore, a change in a woman's hormones may increase or decrease her feelings of well-being. Serotonin receptors, part of the mood mechanism in the brain, have been shown to increase in women who received estrogen patch therapy after menopause, suggesting that estrogen levels may affect mood. The menopause transition may magnify the effect of stress on a depressed mood.

Sleep disturbance and nighttime sweating associated with menopause may lead to increasing levels of fatigue and irritability, which may cause a depressed mood. Various research studies (double-blind trials, longitudinal population-based studies, and longitudinal analysis) support the conclusion that bothersome signs of menopause adversely affect mood.

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