Don’t be surprised if you notice changes in your mood as you approach menopause. During the five to seven years before your periods stop for good, your hormone levels start to change, your periods become less regular, and you may start to have symptoms such as hot flushes, irritability and difficulty sleeping through the night.
According to folklore, serious depression starts at this age, supposedly because women feel ‘useless’ when they lose their fertility. Statistics don’t support this notion; in fact, many women are relieved to leave their child-bearing years behind, and move on to more freedom. All the same, mood changes should be expected. Physical changes such as vaginal dryness and lack of sexual interest may cause irritability.
Changes in hormones, and in your sensitivity to them, may cause increased worry and fatigue, and less ability to cope. They won’t actually cause depression, but they may change the severity of an existing disorder. For example, bipolar disease may not be recognized until the perimenopause. In women who have bipolar illness, the rapid cycling form often begins around this time.
If you have experienced a mood disorder with a pregnancy or on birth control pills, you are more likely to develop a mood disorder when your sex hormone levels change at menopause, and you may require antidepressant treatment. Hormone replacement therapy (HRT) with estrogen and progesterone supplements can also help. HRT ( Hormone replacement therapy )doesn’t treat the depression directly, but it does enhance the effects of any antidepressant medication you may be taking. There has recently been some concern about the safety of HRT. The Committee on the Safety of Medicines advises that use of HRT for more than five years slightly increases the risk of breast cancer. This is something you may wish to discuss with your doctor.
Other changes in your life often happen during the same years as menopause. Children are getting married, going to university, or otherwise leaving home. Elderly parents may need more time and care. Your relationship with your partner may be altering as you both look toward retirement and what you want to accomplish in your remaining time. As women age, of course, they are more likely to lose their partners. About 20 per cent of women who are widowed after age sixty develop depression. If the loss is unexpected or results in decreased financial and emotional security, depression is even more likely to develop.