Researchers have discovered a strong connection between perimenopause and depression, revealing more factors than you might expect.

Perimenopause is the transition that females go through before reaching menopause.

During this time, many experience irregular menstrual periods, fluctuating hormone levels, and insomnia. Hot flashes are also common and can be quite uncomfortable.

In addition to physical changes, some females may also experience emotional changes. In some cases, these emotional cases lead to depression, known as perimenopausal depression.

In fact, researchers have found that approximately 35%Trusted Source of perimenopausal women experience depressive symptoms.

Here’s what that may look like.

Major depressive disorder (MDD) is a serious condition that can be managed with treatment.

Whether experienced during perimenopause or at any other point in your life, the symptoms of the disorder may include:

  • fatigue and lack of energy
  • slowed cognitive function
  • inattentiveness
  • a lack of interest in once-enjoyable activities
  • feelings of worthlessness, hopelessness, or helplessness

In addition to these general symptoms, perimenopausal depression may present with:

Some studies show that fluctuating levels of the female hormone estradiol are one predictor of depression.

Research suggests that estrogen exposure throughout a woman’s lifetime is a predictor of perimenopausal depression.

For instance, a 2018 study found shorter exposure to estrogen—defined as the time from a woman’s first menstruation to the onset of menopause—was associated with a higher likelihood of developing depressive symptoms during the menopausal transition.

In other words, longer durations of estrogen exposure may have a protective effect against depression during the perimenopausal stage.

However, there are several other factors that may account for perimenopausal depression.

A 2010 review of studies, for instance, found that perimenopausal women with no prior history of depression were two to four times more likely to develop depression than women in the premenopause stage.

Hot flashes and their impact on sleep patterns were also implicated in the review.

Stressful life events such as a divorce, job loss, or the death of a parent are common occurrences for people in this stage of life. These events may also trigger depression.

Several other factors have been linked to perimenopausal depression, including:

Many women experience rapid changes in mood during the transition to menopause. These mood changes may be related to fluctuating hormone levels.

When estrogen levels fluctuate, the serotonin and norepinephrine levels in the brain are affected.

Serotonin, norepinephrine, and dopamine are chemicals that work in the brain and play a direct role in your mood. They can make you feel happy by reducing anxiety and improving sleep, among other things.

You experience a general state of calm and well-being when these mood-power players are balanced.

Hormone imbalances — such as your estrogen rising while your progesterone is falling — can inhibit the ability of serotonin and norepinephrine to act as effective neurotransmitters.

The result is mood changes that could lead to depression.

Perimenopause and depression have a complex relationship.

Not only can the effects of perimenopause cause depression, but a 2003 studyTrusted Source found that depression itself may lead to early-onset perimenopause.

The studyfound that women with “significant symptoms of depression in their late 30s and early 40s” were more likely to enter perimenopause before their 45th birthday than women who hadn’t experienced depressive symptoms.

Research was inconclusive as to whether early perimenopause led to early menopause, or if it simply resulted in an extended period of perimenopause.

Lower estrogen levels during both phases are associated with other health risks. These risks include:

Women using antidepressants were three times as likely to enter perimenopause early than those who weren’t, according to the study.

Although antidepressants are linked to an earlier onset of perimenopausal depression, they also help relieve one of its most uncomfortable symptoms.

For instance, research shows that antidepressants, particularly SSRIs and SNRIs, can help lessen the number and intensity of hot flashes in menopausal and postmenopausal women.

The most effective antidepressants for reducing hot flashes were:

  • paroxetine (Paxil)
  • citalopram (Celexa)
  • escitalopram (Lexapro)
  • venlafaxine (Effexor)
  • desvenlafaxine

The researchers noted that the most common side effects of these drugs were nausea and constipation but that the symptoms improved after a week.

A number of home remedies and lifestyle changes can help you manage the symptoms of perimenopausal depression. However, individual should consult with their medical provider when considering taking any supplements.

Regular exercise

Regular exercise can release serotonin and endorphins into the body.

An increase in these chemicals can help people who currently have depression as well as head off depression before it takes hold.

Proper sleep

Adopt good sleep habits, such as going to bed at the same time every night in a quiet, dark, cool room. Avoid using electronics in bed.

Mindful breathing

Mindful breathing is a technique for reducing anxiety. A common technique involves paying attention to your body’s response to natural relaxation as you slowly breathe in—from the abdomen—and then exhale.

Doing this for 15 minutes a day will help bring down your stress levels.

Valerian

The plant valerian may help with perimenopausal depression. Using valerian may also reduceTrusted Source hot flashes and may lead to better sleep.

B vitamins

B vitamins can be important to the mental and emotional well-being of perimenopausal women.

Foods containing these B vitamins include dairy products, leafy green vegetables, and beans. B vitamins are also available in supplement form.

Many women experience depressive symptoms during their transition to menopause.

Recognizing the signs of depression and being aware of changes in your mood can help you take proactive steps to care for your health.

If you’re experiencing depressive symptoms, consider scheduling an appointment with your doctor to discuss treatment options.