DEPRESSIVE SYMPTOMS IN THE PERIMENOPAUSE - PREVALENCE, ASSESSMENT, AND GUIDELINES FOR TREATMENT

This review describes the biological changes occurring in perimenopaus e and analyzes epidemiological studies that shed light on the relation ship between perimenopause and mood. The role of estrogen as a treatme nt for depressive symptoms is also examined. We found that a positive association may exist between depressive symptoms and the perimenopaus e, and that a prior history of depression may be associated with such symptoms. In most of the studies reviewed, the use of estrogen in repl acement doses' appears to improve depressive symptoms in perimenopausa l patients who do not have major depression. We suggest an approach to the treatment of middle-aged women presenting with such symptoms. No careful study of the incidence of DSM-IV major depression associated w ith perimenopause has been done, and the efficacy of estrogen as a pri mary or adjunctive treatment for the disorder during perimenopause is unclear.