What Causes Depression in Perimenopause?
Hold That Pause
Hold That Pause

What Causes Depression in Perimenopause?

A depressed woman.Depression in perimenopause is a big topic. I think depression in general is a big topic, but for women going through perimenopause, it’s huge.  

There are a lot of medical opinions about what causes depression, too. I agree with some of them, but others I dismiss completely out of hand. Especially those which say that if a woman was prone to depression prior to perimenopause, she will likely have problems with it during perimenopause.

Translation: You’re just mentally unstable and perimenopause has nothing to do with it.


I also don’t think depression during perimenopause can be “cured” by simply taking a pill, e.g., an antidepressant. Of course, this doesn’t deter physicians from trying to cure it with a pill. FYI, antidepressants are a multi-billion dollar industry. Let me repeat that: Antidepressants are a multi-billion dollar industry; and guess who’s the major, targeted demographic in that industry?


I’ve already told you what I think about antidepressants for symptoms of perimenopause. But please don’t think I’m judging anyone for taking them. I took them myself when I was going through perimenopause. Like a lot of women, I too was desperate to get relief from the crazy mood swings and gain some measure of control over what was happening to me.

So, I get it. I know why women take them. But that still doesn’t address the underlying issue, and it seems to me that if we are going to be effective in treating depression in perimenopause, we are far better served if we get to the actual source of the problem.

Estrogen, Serotonin, and Depression in Perimenopause

Did you know that there is a direct correlation between a woman’s estrogen levels and the serotonin levels in her brain?  That is, when her estrogen levels rise, her serotonin levels rise. When her estrogen levels fall, her serotonin levels also fall, and that, ladies, is the basic crux of why many women suffer from depression and mood disorders during perimenopause.

Serotonin is the primary brain chemical which regulates mood. When serotonin levels are balanced, we sleep better. We feel secure and safe, mellow and relaxed, hopeful and optimistic, with a general sense of well-being. When serotonin levels are too low, we might feel agitated, irritable, unable to sleep well, and have carbohydrate, sugar, or alcohol cravings. We might also feel anxious and depressed.  

During perimenopause when estrogen and progesterone levels are rising and falling, so too are serotonin levels. Hence, depression and other mood related symptoms in perimenopause. And since antidepressants work by artificially raising serotonin levels in our brain, it’s easy to understand exactly why physicians give them to women suffering from depression in perimenopause.

I understand it, but I don’t necessarily agree with it.

I think there are far better ways to cope with depression during perimenopause without loading up on antidepressants.  The most obvious being addressing hormone imbalance. Beyond that, educating women about the benefits of moderate aerobic exercise and foods which naturally raise serotonin levels are also better alternatives in my view.

But I won’t leave you hanging. Look for more posts for the remainder of the month of March, where I will discuss these alternatives and others, and explore this important topic of depression in perimenopause a little deeper.   

Magnolia Miller is a certified healthcare consumer advocate in women's health and a women's freelance health writer and blogger at The Perimenopause Blog.

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Tags: Life After Menopause , Perimenopause , Symptoms of Menopause

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About the Author

Magnolia is dedicated to empowering women to take responsibility for their own health.