Major depression during and after the menopausal transition: Study of Women's Health Across the Nation (SWAN)
2011/02/09 by Joyce T. Bromberger, J. T. Bromberger, Howard M. Kravitz +9 · 434 citations
Medicine · #Confounding #Demography #Depression (economics) #Internal medicine #Major depressive episode #Medicine #Menopause #Menopause: Health Impacts and Treatments #Mood #Odds ratio #Psychiatry #Psychosocial #Risk factor #Sex and Gender in Healthcare #Sexual function and dysfunction studies
paper · open access · doi:10.1017/s003329171100016x
published in Psychological Medicine 41(9), 1879-1888 (Cambridge University Press)
openalex publication_date 2011/02/09 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/06
Abstract
BACKGROUND: It is unclear whether risk for major depression during the menopausal transition or immediately thereafter is increased relative to pre-menopause. We aimed to examine whether the odds of experiencing major depression were greater when women were peri- or post-menopausal compared to when they were pre-menopausal, independent of a history of major depression at study entry and annual measures of vasomotor symptoms (VMS), serum levels of, or changes in, estradiol (E2), follicular stimulating hormone (FSH) or testosterone (T) and relevant confounders. METHOD: Participants included the 221 African American and Caucasian women, aged 42-52 years, who were pre-menopausal at entry into the Pittsburgh site of a community-based study of menopause, the Study of Women's Health Across the Nation (SWAN). We conducted the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) to assess diagnoses of lifetime, annual and current major depression at baseline and at annual follow-ups. Psychosocial and health factors, and blood samples for assay of reproductive hormones, were obtained annually. RESULTS: Women were two to four times more likely to experience a major depressive episode (MDE) when they were peri-menopausal or early post-menopausal. Repeated-measures logistic regression analyses showed that the effect of menopausal status was independent of history of major depression and annually measured upsetting life events, psychotropic medication use, VMS and serum levels of or changes in reproductive hormones. History of major depression was a strong predictor of major depression throughout the study. CONCLUSIONS: The risk of major depression is greater for women during and immediately after the menopausal transition than when they are pre-menopausal.
Cited by
- A novel method for quantifying affective sensitivity to endogenous ovarian hormones
- Factors Associated with Depression During the Perimenopausal Transition
- Personality, Well-Being, and Health*
- What happens after menopause? (WHAM): A prospective controlled study of depression and anxiety up to 12 months after premenopausal risk-reducing bilateral salpingo-oophorectomy
- Depression during perimenopause: the role of the obstetrician-gynecologist
- EFFICACY OF ESTRADIOL IN PERIMENOPAUSAL DEPRESSION: SO MUCH PROMISE AND SO FEW ANSWERS
- Estrogen-Based Hormone Therapy for Depression Related to Reproductive Events
- Guidelines for the Evaluation and Treatment of Perimenopausal Depression: Summary and Recommendations
- Mood and menopause: findings from the Study of Women's Health Across the Nation (SWAN) over 10 years. [europepmc]
- Cognition and mood in perimenopause: a systematic review and meta-analysis. [europepmc]
- Longitudinal pattern of depressive symptoms around natural menopause. [europepmc]
- Investigation of menopausal stage and symptoms on cognition in human immunodeficiency virus-infected women. [europepmc]
- Risk factors for major depression during midlife among a community sample of women with and without prior major depression: are they the same or different? [europepmc]
- Ovarian hormone fluctuation, neurosteroids, and HPA axis dysregulation in perimenopausal depression: a novel heuristic model. [europepmc]
- Effects of Hormone Therapy on Cognition and Mood in Recently Postmenopausal Women: Findings from the Randomized, Controlled KEEPS-Cognitive and Affective Study. [europepmc]
- EFFICACY OF ESTRADIOL IN PERIMENOPAUSAL DEPRESSION: SO MUCH PROMISE AND SO FEW ANSWERS. [europepmc]
- Estradiol variability, stressful life events, and the emergence of depressive symptomatology during the menopausal transition. [europepmc]
- Perimenopause: From Research to Practice. [europepmc]
- Patterns of depressive disorders across 13 years and their determinants among midlife women: SWAN mental health study. [europepmc]
- Naturally Occurring Changes in Estradiol Concentrations in the Menopause Transition Predict Morning Cortisol and Negative Mood in Perimenopausal Depression. [europepmc]
- Soy and Health Update: Evaluation of the Clinical and Epidemiologic Literature. [europepmc]
- Effects of Resveratrol on Cognitive Performance, Mood and Cerebrovascular Function in Post-Menopausal Women; A 14-Week Randomised Placebo-Controlled Intervention Trial. [europepmc]
- Adverse Childhood Experiences and Risk for First-Episode Major Depression During the Menopause Transition. [europepmc]
- Efficacy of Transdermal Estradiol and Micronized Progesterone in the Prevention of Depressive Symptoms in the Menopause Transition: A Randomized Clinical Trial. [europepmc]
- Understanding the impact of sex and gender in Alzheimer's disease: A call to action. [europepmc]
- Stress Cardiomyopathy Diagnosis and Treatment: JACC State-of-the-Art Review. [europepmc]
- Depression During and After the Perimenopause: Impact of Hormones, Genetics, and Environmental Determinants of Disease. [europepmc]
- Sex differences in Alzheimer's disease: Understanding the molecular impact. [europepmc]
- Estradiol Fluctuation, Sensitivity to Stress, and Depressive Symptoms in the Menopause Transition: A Pilot Study. [europepmc]
- The menopause transition and women's health at midlife: a progress report from the Study of Women's Health Across the Nation (SWAN). [europepmc]
- Impact of Estradiol Variability and Progesterone on Mood in Perimenopausal Women With Depressive Symptoms. [europepmc]
- Menopause and Brain Health: Hormonal Changes Are Only Part of the Story. [europepmc]
- Hormonal Agents for the Treatment of Depression Associated with the Menopause. [europepmc]
Related