Menopause can be difficult for women because of hormonal changes that happen during this time. This stage in a woman's life is associated with a variety of symptoms like mood swings and depression.
Women who suffered trauma and stress during their teens have a greater risk of depression during the years leading into menopause, a new study suggests.
The study was published in the Journal of Clinical Psychiatry.
According to the South African Depression and Anxiety Group (SADAG), it has always been assumed that depression and other psychological symptoms are a standard accompaniment of menopause, but recent studies have refuted this.
Depression is actually more common during the few years before menopause begins, which is known as the perimenopausal stage. But whether certain women might be at higher risk for developing depression during these years has been unclear.
Adverse events may increase risk
"Our results show that women who experience at least two adverse events during their formative years – whether it be abuse, neglect or some type of family dysfunction – are more than twice as likely to experience depression during perimenopause and menopause as women who either experienced those stressors earlier in life, or not at all," said lead author Dr C. Neill Epperson. She's director of the Penn Center for Women's Behavioral Wellness at the University of Pennsylvania's Perelman School of Medicine.
"This suggests that not only does early life stress have significant and long-lasting effects on the development and function of the regions of the brain responsible for emotions, mood, and memory, but the timing of when the event occurs may be equally as important," Epperson said in a university news release.
The study did not prove a cause-and-effect relationship. But the researchers suggest that hormonal changes during menopause may boost a previously undetected risk for depression in women who experienced trauma and stress during their teens.
The new research included almost 250 women. They were between the ages of 35 and 47 at the beginning of the study. Their health was followed for 16 years.
About 22% were diagnosed with major depression before perimenopause. And nearly 21% had their first diagnosis of major depression during perimenopause.
Double the trouble
Women who had two or more incidents of trauma and stress – such as emotional abuse, parental separation or divorce, or living with someone with alcohol or substance addiction – in their teens were 2.3 times more likely to have their first diagnosis of major depression during perimenopause than those who didn't have trauma or stress in their teen years.
However, women who experienced trauma or stress during their teens weren't at increased risk of major depression before perimenopause, the researchers said.
Study senior author Ellen Freeman is a research professor of obstetrics and gynaecology also at Penn. "There's clearly a strong link between childhood adversity and risk of depression, throughout a woman's life, but particularly during the transition to menopause," she said.
"Our study points to the need for more research examining the long-term brain effects of childhood adversity, particularly around the time of puberty," Freeman added.