Depressive symptoms declined after a woman’s final menstrual period, by about 15% per year from the decade before through about 8 years afterward, and the effect depended upon their pre-menopausal history of depression, a small study found.
Researchers conducted a randomly identified, population-based sample in Philadelphia County, Pa. of 203 late-reproductive-age women who were premenopausal at baseline and reached natural menopause. Results appeared online Nov. 13 at JAMA Psychiatry.
The mean age of the women was 42.8 (standard deviation [SD], 3.1) at baseline and 51.1 (SD, 3.3) at the final menstrual period (range, 42-58 years). The cohort was stratified by race, with 47.3% black and 52.7% white women. Also, 44.3% had a history of depression at enrollment.
The prevalence of high scores on the Center for Epidemiologic Studies Depression Scale decreased 15% annually from 10 years before to 8 years after the final menstrual period (odds ratio, 0.85; 95% CI, 0.81 to 0.89; P<0.001), the study found.
A history of depression strongly increased the risk both before and after menopause, researchers found. Women without a history of depression before menopause had a low risk of depressive symptoms 2 or more years after the final menstruation. Women with a history of depression were highly more likely to have high depressive symptoms compared with women without (OR, 13.62; 95% CI, 7.20 to 25.80; P<0.001).
Among women with a history of depression, the likelihood of depressive symptoms was more than 13 times greater overall and 8 times greater after menopause compared with women without depression. Among women who first experienced depressive symptoms approaching menopause, the risk declined after the final menstrual period, with a significantly lower risk two years after menopause.
“Women with a history of depression may benefit from an antidepressant or psychotherapy appropriate for a chronic disorder,” the authors wrote. “However, women with no history of depression may have a low risk of depressive symptoms after the second postmenopausal year and benefit from short-term hormone therapy or short-term treatments with antidepressants that have demonstrated efficacy for menopausal symptoms.”