More than a mood swing
I don't know if I could count the number of menopausal women I've seen who complained of feeling depressed. Sometimes they don't even realize that the two things are linked. But, in fact, doctors have known for a long time that menopause increases a woman's risk of depression.
Until recently, though, no one knew whether menopause could actually cause major depression.
Turns out it can. In a recent study, researchers monitored a group of premenopausal women, ages 36 to 45, with no history of major depression.
During the study, the women who were experiencing perimenopause -- a transition period right before menopause that includes decreased estrogen and progesterone levels and irregular periods -- were twice as likely to experience symptoms of serious depression than the women who were not experiencing menopausal symptoms at all.
The depression risk was even greater in women who had already experienced menopause symptoms like hot flashes and night sweats.
For a lot of women, menopause may be their first experience with true, medical depression. Meanwhile, raging hormones, bodily changes, and stress can make a woman's depression symptoms even worse -- and even harder to recognize if out-of-whack hormones are already making her feel irrational.
That's why, I make sure that I do a proper, full-scale evaluation for depression anytime I have a patient who's experiencing menopause. And your doctor should do the same.
Your doctor should know what's going on in your life -- including whether you're eating properly, getting enough sleep, feeling energetic, etc. And if he finds that you are at risk or even suffering from depression, he should make sure that whatever treatment he recommends is tailored to your needs.
Most of the time, I opt for proven non-drug treatments first -- counseling and psychotherapy, exercise, stress management techniques like biofeedback, or meditation. Milder forms of depression may also respond to rhodiola rosea (I like New Chapter's Rhodiolaforce), or St. John's Wort (try Nature's Way Perika).
Of course, in the most serious cases of depression, a prescription drug like Prozac, Lexapro, or Zoloft may be the best course, but I try to avoid that if possible.
Finally, hormone replacement therapy may be an option for some women, though I tend to shy away from drugs like Premarin or Prempro -- chemical hodgepodges derived from the urine of penned-up pregnant horses, and which some people think could increase your risk of breast cancer and heart disease. Fortunately there are other formulations available that I think are much safer
Studies have shown that using bio-identical hormones (which are chemically synthesized to mimic naturally occurring hormones like estrogen) can be just as effective. These substances are applied and absorbed through the skin, so they aren't processed through the liver the way that oral hormone drugs are. As a result, you can take lower doses and still get the benefits like improved mood, reduced hot flashes, and increased energy. And, even better, a lower dose probably means a lower chance of harmful effects.
Even more evidence that prescription drugs are overused
A recent study has proven something that I've suspected for quite awhile now: Too many doctors are prescribing drugs when they probably shouldn't be.
According to a national survey, more than 1/5 of prescriptions written by doctors were for drugs that hadn't even been approved for the particular medical problems they were supposed to be treating.
This is why I'm always so careful when I prescribe any drug to any patient -- whether it's an antibiotic or an antidepressant. It's not fair to patients to let them spend money on a drug that may or may not work. And it's not safe either.
If your doctor prescribes you a drug, the best question you can ask is "Why?" Make sure that the drug he's giving you is intended for treating your problem. And if it isn't, find a treatment that is.
