No woman probably needs convincing about how difficult the time leading up to the menopause can be. Problems such as significant hot flashes come to the fore in the peri-menopausal period, but they are not the only complaints faced by patients. Indeed, the pre-menopausal period can be associated with the emergence of mental health problems - often overlooked by the patient and those around her.
Variations in the treatment of peri-menopausal depression
In the treatment of peri-menopausal depression, the methods that are used to treat typical affective disorders, namely pharmacotherapy and psychotherapy, are useful. However, this type of depression is characterised by the fact that the therapeutic approach also includes atypical interventions that are not implemented in other forms of affective disorders.
In this case, we are talking about hormone replacement therapy. It appears that exogenous oestrogens make it possible for patients to improve not only their somatic complaints, but also their psychological functioning. However, the introduction of hormone therapy in patients with peri-menopausal depression must be preceded by a thorough assessment of their health and the exclusion of contraindications to its use (such as, for example, an increased tendency to thrombosis or a history of breast cancer).
Before starting any treatment, however, the problem must be diagnosed. As already mentioned, the patient herself may not be aware that her mental state is abnormal. This is where the role of the peri-menopausal woman's family comes into play - if relatives notice any abnormalities, they should try to get the patient to visit at least her family doctor - a specialist will be able to suggest whether she should already be referred to mental health professionals.
Gynaecologists should also be aware of the increased risk of depression in the peri-menopausal period, as they are the ones to whom patients with premenstrual complaints usually turn. These specialists should remember to assess not only their patients' somatic symptoms, but also pay attention to their psychological state.
