Associations between depressed mood and hormonal changes during transition
to menopause are controversial. To our knowledge, there has been no prospective
study of these associations in women commencing when they are premenopausal.
To longitudinally study the associations among reproductive hormones,
menopausal status, and other predictors of depressed mood in midlife women.
Cohort study with 6 assessment periods during a 4-year interval. Blood
samples were collected 12 times during the follicular phase (days 2-6).
Philadelphia County, Pennsylvania.
A randomly identified, population-based, stratified sample of African
American (n = 218) and white (n = 218) women aged 35 to 47 years with regular
menstrual cycles, no hormonal or psychotropic medication use, and no serious
physical or mental health problems at enrollment.
Main Outcome Measures
Center for Epidemiologic Studies Depression Scale score and history
of depression via the Primary Care Evaluation of Mental Disorders.
There was an increased likelihood of depressive symptoms during transition
to menopause and a decreased likelihood after menopause after adjustment for
other predictors of depression, including history of depression, severe premenstrual
syndrome, poor sleep, age, race, and employment status (P = .03). The likelihood of depressive symptoms decreased for individuals
with a rapidly increasing follicle-stimulating hormone profile (P≤.001) and also decreased with age compared with premenopausal
women (P = .02). Participant aggregate profiles with
increasing estradiol levels were significantly associated with depressive
symptoms in bivariate analysis (P = .053).
Depressive symptoms as assessed herein increased during transition to
menopause and decreased in postmenopausal women. Hormone associations provided
corroborating evidence that the changing hormonal milieu contributes to dysphoric
mood during transition to menopause.