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Dealing with Depression During Menopause

Holtorf Medical Group

Unpredictable hormone fluctuations plus stress, body image, sexuality, infertility, or aging — anyone or a combination of these causes emotional distress that may result in mood swings or, in more severe cases, depression. Determining the cause and extent of your “menopause blues” is very important.

The more women experience unusual periods, sporadic cycles, and surprising symptoms, the more it appears that a genuine physiological phenomenon is at play. After having babies and heading into the early 40s, women notice that their bodies are changing and that they are going down the long, hot-flash-ridden path to the “change of life,” or menopause.

The Menopause – Depression Connection

The common mood swings during this time are related to the fluctuating levels of ovarian hormones during the transition to menopause. Plus, if a woman is not sleeping well due to night sweats, her mood would no doubt be affected, too.

Women who had severe PMS in their younger years may have more severe mood swings during perimenopause. Also, women with a history of clinical depression seem to be particularly vulnerable to recurrent clinical depression during menopause.

Perimenopause can begin as early as a woman’s mid-30s and can last anywhere between two to eight years, as a woman’s body begins to wrap up the reproductive years.

The deterioration of the quality of the eggs a woman produces can cause unpredictable cycles for a decade before actual menopause. As some of the ‘poorer quality’ eggs start to develop, they may not develop normally and may not be released in ovulation. If this occurs, it may upset the hormonal balance, which may result in a skipped cycle and perimenopausal symptoms.

As eggs aren’t released as often, progesterone levels drop, and this can cause estradiol levels to fluctuate, which might lead to symptoms of estrogen dominance—heavier menses, bloating, irritability, PMS, breast tenderness, anxiety, hot flashes, heart palpitations, and fibroids. Because these symptoms can often be confused with other health issues, women may overlook perimenopause as a cause.

Dr. Kent Holtorf from Holtorf Medical Group says that “most doctors fail to detect the causative hormonal imbalance because standard blood tests generally miss the hormone imbalance causing the symptoms.”

According to Dr. Holtorf, genetic factors, weight gain, insulin resistance, and even environmental toxins, such as plastics and pesticides, can also affect the timing of perimenopause and menopause.

Depression (as well as weight gain) is typically due to a combination of progesterone and thyroid deficiency. In fact, over 20% of menopausal women in the U.S. are diagnosed with thyroid dysfunction. And it might be worth having these imbalances treated. When these deficiencies are addressed, the overwhelming majority of women will find significant improvement in symptoms.

How to Deal with Depression During Menopause For mild to moderate depression, herbal remedies such as St. John’s wort and the following lifestyle changes may be helpful:

  • Break large tasks into small ones, set some priorities, and do what you can as you can.
  • Participate in activities that may make you feel better such as mild exercise, going to a movie, a ballgame, or participating in religious, social, or other enjoyable activities.
  • Give it time. Expect your mood to improve gradually, not immediately. Feeling better takes time.
  • Postpone important decisions until the depression has lifted. Before deciding to make a significant transition — change jobs, get married or divorced — discuss it with others who know you well and have a more objective view of your situation.

The good news for women experiencing menopausal and depression symptoms is that this can be viewed as a time when they can start thinking more about themselves.

It is a time when women re-evaluate their lives, jobs, and relationships and finally get the strength to do the best for themselves.


Holtorf Medical GroupThe Holtorf Medical Group specializes in optimizing quality of life and being medical detectives to uncover the underlying cause of symptoms, rather than just prescribing medications to cover-up the symptoms. We are experts in natural, prescription bioidentical hormone replacement and optimization, complex endocrine dysfunction, fibromyalgia, chronic fatigue syndrome and Lyme disease. We’ve dedicated our practice to providing you the best in evidenced-based, integrative medicine that’s not only safe and effective, but provides measurable results.


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