Table of ContentsView AllTable of ContentsThe LinkCausesSignsTreatmentWhen to Seek Care
Table of ContentsView All
View All
Table of Contents
The Link
Causes
Signs
Treatment
When to Seek Care
This article is part ofHealth Divide: Menopause and Black Women, a destination in our Health Divide series.
There is a connection betweenmenopauseand depression. According to research, about 41% of postmenopausal people feel depressed.Among menopausal people of different racial and ethnic groups, depression disproportionately affects Black people.
It is important to know the symptoms of depression to help you seek help and form a treatment plan with your healthcare professional.
In this article, learn more about the connection between menopause and depression and the health disparities related to this biological process.
Grace Cary / Getty Images
What’s the Link Between Menopause and Depression?
People assigned female at birth are 2.5 times more likely than people assigned male at birth to experience depression, and research shows this risk is heightened duringmenopause, the transition period between reproductive and nonreproductive ages.
People with no history of depression are nearly twice as likely to experience depression during menopause than premenopausal counterparts.Risk factors like previous depression, adverse life events, andvasomotor symptoms(like hot flashes or night sweats) are at a 2.5 times greater risk of depression during menopause than during the premenopausal stage.
What Is Perimenopause?
Menopause, Depression, and Black Women
The heightened risk for depression during menopause is even greater for Black women, who are more likely than White women to experience more than seven recurrent episodes of depression and less likely to receive treatment for depression.
According to a 2022 analysis of SWAN data between Black and White women, structural racism plays a significant role in the menopausal health inequalities between Black and White women.
Note that when research or health authorities are cited, the terms for sex or gender from the source are used.
What Causes Depression During Menopause?
A large body of research has explored the connection between menopause and depression.Changing hormones, sleep issues, and stress during this life stage, among other factors, may contribute to the greater incidence of depression during menopause.
However, disentangling the various factors that may contribute to a heightened risk of depression during menopause is complicated.
Some risk factors for developing depression during menopause include:
Depression and Age of Menopause Onset
Hormonal Changes
During menopause, hormones are in flux, contributing to various physical and mental symptoms.
It’s likely that the disruption inestrogen, in particular, during menopause, is closely connected to depression. Estrogen helps boost serotonin, a neurotransmitter indicated in depression. When estrogen levels fall during menopause, serotonin levels may also dip, leading to depression.
One study using rats found that the disruption in estrogen during menopause leads to a dysregulation of brain-derived neurotrophic factor (BDNF) and serotonin (5-HT2A). Combined, this made the brain vulnerable to depression.
Other researchers have theorized about the connection between estrogen, menopause, and depression. Because early-onset menopause is associated with a higher risk of depression while late-onset menopause reduces the risk of depression, researchers theorize that estrogen may have a protective effect against depression.
Sleep Problems
Disruptions in sleep during menopause may also contribute to depression.
There is a close link between sleep problems and depression. While sleep problems are a symptom of depression, poor sleep quality may increase the risk for depression. One 2011 meta-analysis found that people with insomnia had a 2 times' greater risk of depression than people without sleep problems.
Vasomotor symptomsof menopause, which include hot flashes and night sweats, can lead to insomnia and difficulty sleeping.
Duringperimenopause, which is the period leading up to menopause in which people experience most symptoms, about 39% to 47% of people have a sleep disorder. After menopause, this ranges from 35% to 60%.
Sleep is another area in which menopausal Black people are disproportionately affected. Black people are 50% more likely than White people to experience hot flashes.They are also less likely to report problems with sleeping. However, they are more likely to score as having poor sleep quality on objective tests.
An Overview of the Link Between Mental Health and Sleep Disorders
Other Menopause Factors
For many people, menopause also occurs during a transition period in which life roles may change. Menopause, which often occurs in the late 40s and through the 50s, may accompany life events like supporting aging parents, children growing up and leaving home, greater responsibility at work, and more. All of these can be mental stressors.
Signs of Depression
Somesymptoms of depressionoverlap withsymptoms of menopause, such as trouble sleeping or concentrating and mood swings.
It’s important to be aware of the signs and symptoms unique to depression, so you can be proactive about seeking treatment.
Some symptoms of depression include:
Black Women Experience More Depressive Symptoms During MenopauseBlack women experience elevated depressive symptoms during menopause. According to the SWAN study, 27.4% of Black women, compared to 22.3% of White women, reported clinically significant depressive symptoms. This occurs because certain depression risk factors, like increased stress, reduced social support, lower economic advantage, and others, are more prevalent in Black women.
Black Women Experience More Depressive Symptoms During Menopause
Black women experience elevated depressive symptoms during menopause. According to the SWAN study, 27.4% of Black women, compared to 22.3% of White women, reported clinically significant depressive symptoms. This occurs because certain depression risk factors, like increased stress, reduced social support, lower economic advantage, and others, are more prevalent in Black women.
Treatment for Menopause-Related Depression
Many people experience depression during menopause, and knowing the symptoms can help you seek treatment faster and get back to feeling well.
Treatmentsfor depression during menopause may include:
Hormone therapy is sometimes used to treat depression symptoms that occur alongside other menopause symptoms, like hot flashes.
Disparities in Depression TreatmentAccording to the SWAN study, Black women are less likely than White women to be treated for depression related to menopause. This includes receiving treatment for emotional problems (43% for Black women vs. 65% for White women), psychotherapy (20% vs. 36%), and prescribed medications (25% vs. 36%).
Disparities in Depression Treatment
According to the SWAN study, Black women are less likely than White women to be treated for depression related to menopause. This includes receiving treatment for emotional problems (43% for Black women vs. 65% for White women), psychotherapy (20% vs. 36%), and prescribed medications (25% vs. 36%).
Lifestyle Changes
You may wish to consider positive lifestyle changes if you’re experiencing depression during menopause.
These include regular exercise, stress and relaxation techniques like yoga and meditation, joining a support group, and more.Specific diets, like alow glycemic index diet(food low in carbohydrates that can raise blood sugar), have also been shown to help with menopausal symptoms like hot flashes.
Consult a trusted healthcare provider before making any significant lifestyle changes. They can advise you on these and other ways to help manage depression.
When to Speak to a Healthcare Provider
If you are in perimenopause, it may be challenging to differentiate between menopausal symptoms and depressive symptoms.
Due to hormonal fluctuations, menopause can lead to mood swings and trouble sleeping. However, if you are in a persistently low mood, with a loss of interest in things you used to enjoy or feelings of guilt or hopelessness, you may have depression, and speaking to a healthcare provider is essential.
Additionally, if menopause symptoms affect your ability to perform your regular duties, tasks, roles, and hobbies, speak to a healthcare provider.
Summary
Depression is more common during menopause and due to socioeconomic factors that disproportionately affect Black people. Black people experience depression during menopause more often than White people but are less likely to receive treatment.
These health disparities reflect the impacts of structural racism on certain communities affecting equal access to public services like education and health care, other goods and services, and opportunities, which all compromise the quality of care received, even when it is accessible.
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ozdemir K, Sahin S, Guler DS, Unsal A, Akdemir N.Depression, anxiety, and fear of death in postmenopausal women.Menopause. 2020;27(9):1030-1036. doi: 10.1097/GME.0000000000001578Harlow SD, Burnett-Bowie SAM, Greendale GA, et al.Disparities in reproductive aging and midlife health between black and white women: the study of women’s health across the nation(SWAN).Women’s Midlife Health. 2022;8(1):3. doi: 10.1186/s40695-022-00082-xChhibber A, Woody S, Rumi M, Soares M, Zhao L.Estrogen receptor β deficiency impairs BDNF–5-HT2A signaling in the hippocampus of female brain: A possible mechanism for menopausal depression.Psychoneuroendocrinology. 2017;82:107-116. doi: 10.1016/j.psyneuen.2017.05.016Freeman EW.Depression in the menopause transition: risks in the changing hormone milieu as observed in the general population.Women’s Midlife Health. 2015;1(1):2. doi: 10.1186/s40695-015-0002-ySantoro N, Taylor ES, Sutton-Tyrrell K.The swan song: study of women’s health across the nation’s recurring themes.Obstet Gynecol Clin North Am. 2011;38(3):417-423. doi: 10.1016%2Fj.ogc.2011.05.001Vivian-Taylor J, Hickey M.Menopause and depression: Is there a link?Maturitas. 2014;79(2):142-146. doi: 10.1016/j.maturitas.2014.05.014Georgakis MK, Thomopoulos TP, Diamantaras AA, et al.Association of age at menopause and duration of reproductive period with depression after menopause: a systematic review and meta-analysis.JAMA Psychiatry. 2016;73(2):139-149. doi: 10.1001/jamapsychiatry.2015.2653Johns Hopkins Medicine.Can menopause cause depression?Baglioni C, Battagliese G, Feige B, et al.Insomnia as a predictor of depression: A meta-analytic evaluation of longitudinal epidemiological studies.J Affect Disord. 2011;135(1-3):10-9. doi:10.1016/j.jad.2011.01.011Harvard Health.Menopause and insomnia: could a low GI diet help?Anxiety & Depression Association of America.Depression symptoms.Herson M, Kulkarni J.Hormonal agents for the treatment of depression associated with the menopause.Drugs Aging. 2022;39(8):607-618. doi: 10.1007%2Fs40266-022-00962-xDwyer JB, Aftab A, Radhakrishnan R, et al.Hormonal Treatments for Major Depressive Disorder: State of the Art.Am J Psychiatry. 2020;177(8):686-705. doi:10.1176/appi.ajp.2020.19080848Zhao JL, Jiang WT, Wang X, Cai ZD, Liu ZH, Liu GR.Exercise, brain plasticity, and depression. CNS Neurosci Ther. 2020 Sept;26(9):885-895. doi:10.1111/cns.13385
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ozdemir K, Sahin S, Guler DS, Unsal A, Akdemir N.Depression, anxiety, and fear of death in postmenopausal women.Menopause. 2020;27(9):1030-1036. doi: 10.1097/GME.0000000000001578Harlow SD, Burnett-Bowie SAM, Greendale GA, et al.Disparities in reproductive aging and midlife health between black and white women: the study of women’s health across the nation(SWAN).Women’s Midlife Health. 2022;8(1):3. doi: 10.1186/s40695-022-00082-xChhibber A, Woody S, Rumi M, Soares M, Zhao L.Estrogen receptor β deficiency impairs BDNF–5-HT2A signaling in the hippocampus of female brain: A possible mechanism for menopausal depression.Psychoneuroendocrinology. 2017;82:107-116. doi: 10.1016/j.psyneuen.2017.05.016Freeman EW.Depression in the menopause transition: risks in the changing hormone milieu as observed in the general population.Women’s Midlife Health. 2015;1(1):2. doi: 10.1186/s40695-015-0002-ySantoro N, Taylor ES, Sutton-Tyrrell K.The swan song: study of women’s health across the nation’s recurring themes.Obstet Gynecol Clin North Am. 2011;38(3):417-423. doi: 10.1016%2Fj.ogc.2011.05.001Vivian-Taylor J, Hickey M.Menopause and depression: Is there a link?Maturitas. 2014;79(2):142-146. doi: 10.1016/j.maturitas.2014.05.014Georgakis MK, Thomopoulos TP, Diamantaras AA, et al.Association of age at menopause and duration of reproductive period with depression after menopause: a systematic review and meta-analysis.JAMA Psychiatry. 2016;73(2):139-149. doi: 10.1001/jamapsychiatry.2015.2653Johns Hopkins Medicine.Can menopause cause depression?Baglioni C, Battagliese G, Feige B, et al.Insomnia as a predictor of depression: A meta-analytic evaluation of longitudinal epidemiological studies.J Affect Disord. 2011;135(1-3):10-9. doi:10.1016/j.jad.2011.01.011Harvard Health.Menopause and insomnia: could a low GI diet help?Anxiety & Depression Association of America.Depression symptoms.Herson M, Kulkarni J.Hormonal agents for the treatment of depression associated with the menopause.Drugs Aging. 2022;39(8):607-618. doi: 10.1007%2Fs40266-022-00962-xDwyer JB, Aftab A, Radhakrishnan R, et al.Hormonal Treatments for Major Depressive Disorder: State of the Art.Am J Psychiatry. 2020;177(8):686-705. doi:10.1176/appi.ajp.2020.19080848Zhao JL, Jiang WT, Wang X, Cai ZD, Liu ZH, Liu GR.Exercise, brain plasticity, and depression. CNS Neurosci Ther. 2020 Sept;26(9):885-895. doi:10.1111/cns.13385
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Ozdemir K, Sahin S, Guler DS, Unsal A, Akdemir N.Depression, anxiety, and fear of death in postmenopausal women.Menopause. 2020;27(9):1030-1036. doi: 10.1097/GME.0000000000001578Harlow SD, Burnett-Bowie SAM, Greendale GA, et al.Disparities in reproductive aging and midlife health between black and white women: the study of women’s health across the nation(SWAN).Women’s Midlife Health. 2022;8(1):3. doi: 10.1186/s40695-022-00082-xChhibber A, Woody S, Rumi M, Soares M, Zhao L.Estrogen receptor β deficiency impairs BDNF–5-HT2A signaling in the hippocampus of female brain: A possible mechanism for menopausal depression.Psychoneuroendocrinology. 2017;82:107-116. doi: 10.1016/j.psyneuen.2017.05.016Freeman EW.Depression in the menopause transition: risks in the changing hormone milieu as observed in the general population.Women’s Midlife Health. 2015;1(1):2. doi: 10.1186/s40695-015-0002-ySantoro N, Taylor ES, Sutton-Tyrrell K.The swan song: study of women’s health across the nation’s recurring themes.Obstet Gynecol Clin North Am. 2011;38(3):417-423. doi: 10.1016%2Fj.ogc.2011.05.001Vivian-Taylor J, Hickey M.Menopause and depression: Is there a link?Maturitas. 2014;79(2):142-146. doi: 10.1016/j.maturitas.2014.05.014Georgakis MK, Thomopoulos TP, Diamantaras AA, et al.Association of age at menopause and duration of reproductive period with depression after menopause: a systematic review and meta-analysis.JAMA Psychiatry. 2016;73(2):139-149. doi: 10.1001/jamapsychiatry.2015.2653Johns Hopkins Medicine.Can menopause cause depression?Baglioni C, Battagliese G, Feige B, et al.Insomnia as a predictor of depression: A meta-analytic evaluation of longitudinal epidemiological studies.J Affect Disord. 2011;135(1-3):10-9. doi:10.1016/j.jad.2011.01.011Harvard Health.Menopause and insomnia: could a low GI diet help?Anxiety & Depression Association of America.Depression symptoms.Herson M, Kulkarni J.Hormonal agents for the treatment of depression associated with the menopause.Drugs Aging. 2022;39(8):607-618. doi: 10.1007%2Fs40266-022-00962-xDwyer JB, Aftab A, Radhakrishnan R, et al.Hormonal Treatments for Major Depressive Disorder: State of the Art.Am J Psychiatry. 2020;177(8):686-705. doi:10.1176/appi.ajp.2020.19080848Zhao JL, Jiang WT, Wang X, Cai ZD, Liu ZH, Liu GR.Exercise, brain plasticity, and depression. CNS Neurosci Ther. 2020 Sept;26(9):885-895. doi:10.1111/cns.13385
Ozdemir K, Sahin S, Guler DS, Unsal A, Akdemir N.Depression, anxiety, and fear of death in postmenopausal women.Menopause. 2020;27(9):1030-1036. doi: 10.1097/GME.0000000000001578
Harlow SD, Burnett-Bowie SAM, Greendale GA, et al.Disparities in reproductive aging and midlife health between black and white women: the study of women’s health across the nation(SWAN).Women’s Midlife Health. 2022;8(1):3. doi: 10.1186/s40695-022-00082-x
Chhibber A, Woody S, Rumi M, Soares M, Zhao L.Estrogen receptor β deficiency impairs BDNF–5-HT2A signaling in the hippocampus of female brain: A possible mechanism for menopausal depression.Psychoneuroendocrinology. 2017;82:107-116. doi: 10.1016/j.psyneuen.2017.05.016
Freeman EW.Depression in the menopause transition: risks in the changing hormone milieu as observed in the general population.Women’s Midlife Health. 2015;1(1):2. doi: 10.1186/s40695-015-0002-y
Santoro N, Taylor ES, Sutton-Tyrrell K.The swan song: study of women’s health across the nation’s recurring themes.Obstet Gynecol Clin North Am. 2011;38(3):417-423. doi: 10.1016%2Fj.ogc.2011.05.001
Vivian-Taylor J, Hickey M.Menopause and depression: Is there a link?Maturitas. 2014;79(2):142-146. doi: 10.1016/j.maturitas.2014.05.014
Georgakis MK, Thomopoulos TP, Diamantaras AA, et al.Association of age at menopause and duration of reproductive period with depression after menopause: a systematic review and meta-analysis.JAMA Psychiatry. 2016;73(2):139-149. doi: 10.1001/jamapsychiatry.2015.2653
Johns Hopkins Medicine.Can menopause cause depression?
Baglioni C, Battagliese G, Feige B, et al.Insomnia as a predictor of depression: A meta-analytic evaluation of longitudinal epidemiological studies.J Affect Disord. 2011;135(1-3):10-9. doi:10.1016/j.jad.2011.01.011
Harvard Health.Menopause and insomnia: could a low GI diet help?
Anxiety & Depression Association of America.Depression symptoms.
Herson M, Kulkarni J.Hormonal agents for the treatment of depression associated with the menopause.Drugs Aging. 2022;39(8):607-618. doi: 10.1007%2Fs40266-022-00962-x
Dwyer JB, Aftab A, Radhakrishnan R, et al.Hormonal Treatments for Major Depressive Disorder: State of the Art.Am J Psychiatry. 2020;177(8):686-705. doi:10.1176/appi.ajp.2020.19080848
Zhao JL, Jiang WT, Wang X, Cai ZD, Liu ZH, Liu GR.Exercise, brain plasticity, and depression. CNS Neurosci Ther. 2020 Sept;26(9):885-895. doi:10.1111/cns.13385
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