The Hottest Debate in Medicine: Menopause and Depression

Put one hundred gynecologists, family practice physicians, and mental health professionals in a room together, and ask them if menopause and depression are related, and the debate will immediately grow heated and very unpleasant. Non-combatants will be startled as to just how intense this debate really is. Each side will produce various medical studies, patient questionnaires, and psychopharmacology “proof” that menopause is or is not related to depression.

Where does this debate leave menopausal women? Caught in the middle of the debate of the experts, the only option that women seem to have is to listen to both sides, do their own research, and then form their own opinion about menopause and depression. No matter how thin you pound a pancake, it still has two sides.

What’s the Problem?

Menopausal women with no prior history of depression often experience depressive symptoms during pre-menopause and actual menopause. If menopause isn’t related to depression, then why are so many menopausal women depressed? The medical and mental health research in this area is nothing but confusing. Some studies report no correlation between menopause and depression, and other studies report just the opposite. Thus, the exact relationship between menopause and depression remains unclear.

Since the experts cannot agree on this issue, it falls to each woman to make the connection or not. A menopausal woman who is experiencing symptoms of depression should see both a gynecologist and a psychiatrist. Symptoms of depression include insomnia, lack of pleasure in normal activities, feeling hopeless and helpless, inability to focus and concentrate, mood irritability, and suicidal ideation.

At this point, the debate about menopause and depression becomes unimportant; the woman’s depression must be treated since they are at high risk for suicide. Antidepressant medication and psychotherapy are the best treatments for depression in general. Once the woman’s depression is being resolved, her physician can treat her menopause medical issues.

Research has uncovered an interesting finding: sometimes the relationship between menopause and depression appears to be hereditary, and may have a genetic biological base. Thinking back to their mothers, grandmothers and sisters, women are often recalling that their blood female relatives experienced menopause and depression. This may not convince medical scientists, but it may convince the woman herself that she may be experiencing menopause-related depression.

Even more telling is that women who experienced an episode of depression prior to menopause tend to report feeling depressed during pre and actual menopause. Regardless, the debate about menopause and depression shows no sign of resolution. Most physicians do the safe and wisest thing: treat both conditions.

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