Depression, anxiety and menopause
The menopause occurs when normal function of the ovaries ceases and blood levels of the hormone oestrogen drop precipitously. It also occurs following surgical removal of the ovaries (surgical menopause).
Transition through this change in hormones is marked by intense hormonal fluctuations, and may be accompanied by hot flushes and sweats, sleep disturbances, changes in sexual function and increased risk for osteoporosis and cardiovascular disease. However, there is enormous variation in how each woman experiences this normal life phase.
Mood and menopause
Many women report mood changes around the time of their menopause-classically heightened anxiety and depressive symptoms. Women often report less ability to cope with routine situations, loss of concentration, loss of self-esteem and loss of confidence.
Up to 15% of all women report depressive symptoms related to menopause.
In women who have severe night time hot flushes and sweats, these symptoms may in part be due to lack of sleep. However, the changes in hormone levels that occur at the time of menopause are associated with anxiety and lowered mood.
30% of Australian women aged 40-65 years who experience moderate-severe hot flushes/night sweats experience moderate to severe depressive symptoms.
Other factors associated with depressive symptoms in Australian women at this time include:
- housing insecurity
- not being in paid employment
- morbid obesity (body mass index of 40 kg/m2 or more)
- being unpartnered (adjusted OR 2.06, 95% CI, 1.57-2.71, p<0.001) .
What are the treatment options for women who experience depression at menopause?
If you experience depressed mood at any time you should consult your family doctor. Your doctor should review your general health and wellbeing, stress levels, relationships and identify any factors that may have caused the depression. You may find the support of a psychologist very helpful.
If your first experience of anxiety/depressed mood is at the time of menopause, and especially if your mood change is associated with hot flushes/ night sweats, you should discuss the pros and cons of hormone therapy with your doctor as menopausal hormone therapy may alleviate the anxiety and lowered mood.
Australian women are more likely to smoke, drink excess alcohol and take anti-depressant medications around the time of menopause. It is important you discuss all these issues with your doctor and seek support if you feel you are not coping.