Postpartum and Perimenopause Depression – What is the connection?

May 18, 2023.

Changes in mood are common during perimenopause. Studies have found that the risk of perimenopause depression is two to five times greater than during a woman’s premenopausal years. Depression can have a huge impact on a woman’s quality of life.

Postpartum depression is also common, affecting up to 20% of mothers. In both postpartum and perimenopause depression, hormonal changes are believed to play a major role in causing the condition. Because of this, it makes sense to wonder whether women who had postpartum depression are more likely to experience depression again during perimenopause.

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How do hormonal changes influence the risk of depression?

In general, the risk of depression is significantly higher for women than for men. Although there are many possible reasons for this, decades’ worth of research indicates that hormones play a huge role.

Many different regions of the brain contain receptors for both estrogen and progesterone, including areas that are involved in regulating mood. In fact, there’s a particularly high density of these receptors in areas like the amygdala and the hippocampus, which are involved in mood as well as memory and cognition. Changes in the levels of these hormones influence the function of these brain regions, which could help to explain the increased risk of depression around times of hormonal fluctuation, such as pregnancy and menopause.

Estrogen and progesterone have also been shown to influence the levels of various neurotransmitters (signaling chemicals) in the brain, including serotonin and dopamine, both of which are known to be involved in mood. There’s even evidence that estrogen and progesterone influence the growth of neurons in the brain, as well as their ability to make new connections.

Does postpartum depression raise the risk of perimenopause depression?

One large study of more than 200,000 women found that having experienced depression at any previous time led to a greater risk for perimenopause depression. However, the timing wasn’t necessarily important – those who had experienced postpartum depression had a similar risk as those who had experienced depression at some other time.

It might not be that postpartum depression specifically raises the risk of perimenopause depression. Instead, women whose brains are more sensitive to hormonal fluctuations are more likely to experience depression at any time of hormonal change. In addition, some women are generally more vulnerable to depression than others are. Perimenopause and giving birth are both possible triggers for depression in those who are more sensitive.

How can perimenopause depression be managed?

Because depression is so strongly linked to hormonal fluctuations, researchers have investigated the use of hormone therapy for perimenopause depression. In fact, taking estrogen has been shown to be beneficial for many women experiencing depression around the time of menopause. Some studies have also shown a benefit from taking DHEA, which is a precursor to all of the sex hormones, including estrogen, progesterone, and testosterone. 

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If you’re interested in trying hormone therapy for depression or other symptoms of perimenopause, it’s best to have a health professional prescribe and monitor your hormone treatment, rather than trying to do it yourself using over-the-counter supplements. This will help to ensure that your treatment is as safe and effective as possible. There are significant risks associated with self-treatment using hormone supplements, so it’s much safer to work with a medical professional.

Hormones are not the only possible treatment for perimenopause depression. Some women benefit from taking antidepressants. There are also a variety of social factors that may play a role, such as stress. A counselor or therapist might be able to help you discover techniques for managing stress and changing any negative thought patterns that might be contributing to your depression.

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If you’re experiencing perimenopause depression, you don’t simply have to live with it. There are effective treatments that can help you feel better. Depression at any point in your life is not your fault, and seeking help for your symptoms is not at all a sign of weakness, any more than seeking help for a cough would be. Don’t be afraid to reach out to a healthcare professional for help.

Disclaimer: This is not medical advice, does not take the place of medical advice from your physician, and is not intended to treat or cure any disease. Patients should see a qualified medical provider for assessment and treatment.

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Patricia Shelton

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