In the years before and after menopause, many women struggle with mood swings, depression, anxiety, and general irritability. Of those, however, depression is a significant concern. Your risk for depression increases two- to three-fold during perimenopause and early postmenopause. And it often causes symptoms severe enough to interfere with your ability to work and enjoy life.
Depending on the severity and cause of your depression, you may need treatments such as antidepressants. However, bioidentical hormone replacement therapy can help prevent menopause-associated depression. Studies show that hormone replacement may cut your risk in half and improve existing symptoms.
When you come to Gynecologic Surgery and Menopause Solutions, you receive comprehensive and compassionate women’s health care, which includes help for any mental health problems. We take the time to talk with you about your worries, define the symptoms, and help you find the best treatment.
What you should know about perimenopause and menopause
Perimenopause is often called the transition to menopause because it’s a stage of menopause that begins when your hormones start to fluctuate, but before you reach menopause. These hormonal ups-and-downs can begin three to five years before menopause, and they’re significant enough to affect your physical and emotional health.
During perimenopause, your menstrual periods start to change, and you can experience all the classic menopause symptoms, including hot flashes, night sweats, and mood swings. Then you officially enter menopause when you haven’t had a period for 12 consecutive months. You’re more likely to become depressed during perimenopause and in the early years after menopause than at any other time of your life.
Loss of estrogen during menopause affects brain chemicals
Estrogen doesn’t just influence your reproductive cycles, it also actively regulates many systems in your body, including your central nervous system. It turns out that sex hormones affect neurotransmitters, and your brain needs estrogen to regulate emotions and cognition.
Estrogen stimulates serotonin synthesis and prevents the breakdown of serotonin and norepinephrine, two neurotransmitters that are essential for maintaining a healthy, balanced mood. As estrogen declines during perimenopause and menopause, neurotransmitter production and activity drops, and you become highly susceptible to depression.
Lack of sleep
Failing to get a good night’s sleep is a major challenge for many women during menopause. You may have trouble sleeping because severe hot flashes and night sweats wake you throughout the night. Low levels of progesterone — another hormone that declines at menopause — also affect your ability to sleep, as progesterone has a calming effect.
Low levels of estrogen and progesterone may also increase the chance of developing sleep apnea. When you have sleep apnea, you’ll wake 5-30 times or more every hour. Needless to say, sleep apnea seriously disrupts your sleep.
When you have trouble sleeping, you’re 10-times more likely to become clinically depressed. The more often you wake during the night because of night sweats or sleep apnea, the higher your risk of depression.
Multitude of changes influence your mental health
On average, women enter menopause around the age of 51 years, a time when many changes occur that can lead to depression. Your children may leave home for the first time, or you could take over as the primary caretaker for aging parents.
You’re also at a higher risk for chronic disease and general muscle aches. Keeping up with a thriving social life becomes a challenge for some, and that lack of connection causes depression.
Any one of these changes alone could trigger depression, but combined with the powerful influence of hormonal changes, women face a significant risk of depression and other mental health problems. For example, you’re more likely to have your first panic attack or develop obsessive-compulsive disorder during perimenopause.
You have a lot to keep up with, but you can depend on us to provide the support you need. When you start to experience physical and emotional changes during perimenopause or menopause, call Gynecologic Surgery and Menopause Solutions, or schedule an appointment online. We’ll get to the cause of your symptoms and provide optimal treatment.