Many studies have shown an increased risk of depression in women during the menopausal years. Women most at risk are those who have a history of depression, a recent stressful life event, lack of social support, are obese, smoke or who have an early onset of the depressive symptoms in women with these risk factors. These symptoms tend to precede hot flashes.
Aging itself is the main cause of cognitive decline. However, many women complain of changes in their memory during the menopausal years, mostly affecting verbal memory. Along with these symptoms, women can also experience a decline in sexual desire.
Initial evaluation should include blood testing to rule out thyroid disorders and low vitamin B12.
Many women turn to hormone replacement therapy to counteract the effect of lack of estrogen. It has been shown that there is less cognitive decline if hormone replacement is initiated before the complete cessation of menses. While estrogen can be helpful in treating perimenopausal depression and changes in sexual function, the first line of treatment of major depression requires pharmacotherapy and psychotherapy.
Along with the traditional well-known medications like Prozac and Zoloft, a new category of antidepressants has emerged. This class of drugs is able to control depressive symptoms without affecting sexual function. Also, because of their effect on a hormone in the brain called norepinephrine, they avoid the “aloof” feeling cause by long-term use of traditional antidepressants.
In conclusion, a healthy diet, maintaining a healthy weight and exercise can help lessen the hormonal changes of menopause. However, if you experience any of the symptoms described above, you are not delusional. Share your thoughts with your Doctor – and help is always available.