Depression During and After the Perimenopause: Impact of Hormones, Genetics, and Environmental Determinants of Disease

Obstet Gynecol Clin North Am. 2018 Dec;45(4):663-678. doi: 10.1016/j.ogc.2018.07.007. Epub 2018 Oct 25.


Vulnerability to depression is increased across the menopause transition and in the early years after the final menstrual period. Clinicians should systematically screen women in this age group; if depressive symptoms or disorder are present, treatment of depression should be initiated. Potential treatments include antidepressants for moderate to severe symptoms, psychotherapy to target psychological and interpersonal factors, and hormone therapy for women with first-onset major depressive disorder or elevated depressive symptoms and at low risk for adverse effects. Behavioral interventions can improve physical activity and sleep patterns.

Keywords: Depression; Genetics; Hormones; Perimenopause; Psychosocial and health factors.

Publication types

  • Review

MeSH terms

  • Antidepressive Agents
  • Cognitive Behavioral Therapy
  • Depression / etiology
  • Depression / metabolism
  • Depression / physiopathology*
  • Female
  • Gene-Environment Interaction
  • Gonadal Steroid Hormones / metabolism*
  • Hormone Replacement Therapy
  • Humans
  • Longitudinal Studies
  • Perimenopause / metabolism
  • Perimenopause / physiology
  • Perimenopause / psychology*
  • Psychotherapy


  • Antidepressive Agents
  • Gonadal Steroid Hormones