Perimenopausal women have a 40% higher risk of suffering depression than those experiencing no menopausal symptoms, research suggests.
Experts from University College London (UCL) found women could be vulnerable to depression and anxiety in the run-up to their periods stopping, with the development of new cases or existing symptoms getting worse.
Women typically go through the menopause aged 49 to 52, which has been highlighted previously as the point at which women experience the highest rates of depression.
According to the NHS, common mental health symptoms of menopause and perimenopause include low mood, anxiety, mood swings, low self-esteem and issues with memory and concentration.
Physical symptoms include hot flushes, difficulty sleeping, heart palpitations, muscle aches and joint pains, and weight gain.
The new research, published in the Journal of Affective Disorders, examined data from seven studies involving 9,141 women from across the world, including Australia, the US, China, Netherlands and Switzerland.
It concluded that perimenopausal women were “at a significantly higher risk for depressive symptoms and diagnoses” compared to premenopausal women.
Furthermore, researchers did not find a significantly increased risk for depressive symptoms in post-menopausal women, when compared to those who were premenopausal.
The team suggested that one biological reason – discussed in previous research – is that the drop in oestrogen women experience during menopause triggers the onset of new symptoms or the worsening of pre-existing depressive symptoms.
They said oestrogen “has been found to affect the metabolism of neurotransmitters (dopamine, norepinephrine, beta-endorphin, and serotonin), all of which influence emotional states.”
Night sweats can also lead to sleep problems, which may also have an influence, though this is not conclusive, they added.
Having a previous history of depression has also been associated with depression in women with menopause, while other studies have said caring for both ageing parents and children may make women more vulnerable.
Lead author and UCL Masters student Yasmeen Badawy said: “Combining data from global studies indicates that these findings cannot be attributed to cultural factors or lifestyle changes alone which have been sometimes used to explain the depressive symptoms that women experience during perimenopause.”
Senior author Dr Roopal Desai said: “This study shows that women in the perimenopausal stage are significantly more likely to experience depression than either before or after this stage.
“Our findings emphasise the importance of acknowledging that women in this life-stage are more vulnerable to experiencing depression.
“It also underlines the need to provide support and screening for women to help address their mental health needs effectively.”
In a previous study, the same researchers found that therapy – such as mindfulness and cognitive behavioural therapy – could be an effective form of treatment for non-physical symptoms of the menopause.
Corresponding author Professor Aimee Spector said: “Women spend years of their lives dealing with menopausal symptoms that can have a huge impact on their wellbeing and quality of life.
“Our findings show just how significantly the mental health of perimenopausal women can suffer during this time.
“We need greater awareness and support to ensure they receive appropriate help and care both medically, in the workplace and at home.”
The authors said one limitation of their work was that the study was unable to account for whether the women had a previous history of depression.