Depression and the menopause

BMJ 1997; 314 doi: https://doi.org/10.1136/bmj.314.7085.977a (Published 29 March 1997) Cite this as: BMJ 1997;314:977

Oestrogens improve symptoms in some middle aged women

  1. John Studd, Consultant gynaecologista
  1. a Chelsea and Westminster Hospital, London SW10 9NH
  2. b Subdepartment of Clinical Psychology, University College London, London WC1E 6BT

    Editor–In her editorial Myra S Hunter repeatedly makes the point that depression should not automatically be blamed on the menopause.1 Nobody would disagree with that, but we need to know whether depression is more common in women in the years running up to the menopause, whether it is related to hormonal changes, and whether it can be effectively treated by hormone replacement.

    Hunter's monocular vision on the subject and her eccentric choice of references do not allow us to answer any of these questions. The menopause is the time of the last menstrual period and therefore statements such as “a longer menopause (at least 27 months) was associated with an increased but transitory risk of depression” are not easy to interpret.1 She is probably correct in that it is difficult to associate either the cause or the treatment of postmenopausal depression with oestrogens, and our studies have shown considerable improvement only in premenopausal women.2 3 Indeed, many women feel well for the first time in many years when the menopause removes their …

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