Depression and Anxiety Symptoms in Midlife Women Vary with Menopausal Status

JANUARY 22, 2018
Jennifer DiSanto
A midlife woman’s menopausal status is associated with her risk of depression and anxiety symptoms, according to a recently published report.

In the article, Stephanie Mulhall, Psychologist at Research School of Psychology, College of Health & Medicine, the Australian National University, and colleagues noted that female reproductive course could be classified into 3 stages: premenopause, perimenopause, and postmenopause.

During perimenopause, women are more likely to experience symptoms of depression, and during postmenopause, they are more likely to experience anxiety symptoms. Even women with no history of depression or anxiety are at increased risk for these symptoms during perimenopause and postmenopause, compared with their risk during premenopause, according to the study.

Mulhall and colleagues conducted the study to assess depression and anxiety symptoms in relation to menopausal status in a group of midlife women. The study participants were women of mean age 50.6±1.5, including 237 premenopausal women, 249 perimenopausal, and 225 postmenopausal, selected from a longitudinal study called the Personality and Total Health (PATH) Through Life Project.

The research team used the Goldberg Depression Scale and Goldberg Anxiety Scale to determine the women’s depression/anxiety symptoms, along with generalized linear regression models with a negative binomial log link.

According to the published results, relative to premenopause and after adjusting for all relevant variables, being perimenopausal was associated with increased risk of greater symptoms of depression (IRR=1.29; P = 0.001).

Being postmenopausal was associated with increased risk of greater symptoms of anxiety (IRR = 1.15, P = 0.041), while the perimenopausal and postmenopausal stages were associated with an increased risk of greater symptoms of depression (IRR = 1.35, P = 0.008; IRR = 1.31, P = 0.029; respectively) and anxiety (IRR = 1.22, P = 0.030; IRR = 1.32, P = 0.006; respectively) in women with no history of probable major depressive disorder (MDD) or generalized anxiety disorder (GAD).

Risk of symptoms did not differ with menopausal status in women with this history.

“Menopausal status was associated with psychological symptoms in women without a history of probable MDD or GAD, whereby being perimenopausal or postmenopausal was associated with increased risk of symptoms of depression and anxiety,” researchers wrote. “In women with a probable history of MDD or GAD, menopausal status was not associated with this risk.”

Lead author Stephanie Mulhall, told MD Magazine that the results suggest the risk of MDD and GAD symptoms differs based on menopausal status, “even after factors that ordinarily increase risk are accounted for.”

“When assessing and treating midlife women, practitioners may consider menopausal status in addition to other risk factors,” Mulhall said. “Our findings also indicate that women who do not have a history of symptoms of anxiety or depression may be at greater risk of experiencing these symptoms than those with this history.

Future identification of symptom changes during midlife will give researchers the opportunity to monitor and appropriately treat symptoms when they occur, Mulhall said.

“Clinically, it is worth considering menopausal status in addition to individual history and established risk factors during the assessment and treatment of women in midlife who report psychological symptoms,” researchers wrote.

The study, "Variation in symptoms of depression and anxiety in midlife women by menopausal status," was published online in The European Menopause Journal.

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