Life Cycle and Depression: Perimenopause

If a perimenopausal woman has a history of depression, it makes sense to treat her with psychotherapy and the antidepressant that was helpful for her earlier depression(s). If this treatment fails or works only partially, I refer the woman to her gynecologist. Estrogen can help ease depression in perimenopausal women. However there have been conflicting data and much controversy around the use of estrogen; it is best for the woman and her gynecologist to discuss this issue thoroughly.

If a perimenopausal woman is depressed and also having severe hot flashes, but cannot take estrogen, she may be a candidate for treatment with paroxetine (Paxil), fluoxetine (Proxac), or venlafaxine (Effexor). These three antidepressants are thought to decrease hot flashes.

Good self-care can also help to alleviate depressive symptoms during perimenopause. Regular exercise, abstaining from alcohol and nicotine, along with a healthy diet go a long way toward keeping a woman in good health, no matter what stage of life she is experiencing.


REFERENCES:

Pearson, Kimberly H, MD, Shamsah B Sonawalla, MD, and Jerrold F. Rosenbaum, MD. Women's Health and Psychiatry. Lippincott Williams & Wilkins, 2002.
Vliet, Elizabeth Lee. It's My Ovaries, Stupid!Scribner, 2003.
Vliet, Elizabeth Lee. Sreaming to Be Heard:Hormonal Connections Women Suspect, and Doctors Still Ignore. Evans & Co, 2nd edition, 2001.
Weed, Susun s. New Menopausal Years, The Wise Woman Way: Alternative Approaches for Women 30-90. Ash Tree Pub; Revised edition, 2001.

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