Among a large cohort of Canadian women, premature menopause and current use of hormone therapy were associated with self-reported depression, according to results from a study published in Menopause.

“A particularly vulnerable time for women occurs during the menopausal transition, which is marked by drastic fluctuations in sex hormones,” Alison K. Shea, MD, PhD, FRCSC, department of obstetrics and gynecology, faculty of health sciences at McMaster University in Ontario, Canada, and colleagues wrote. “The main objective of this research was to investigate the association between menopausal status and self-reported depressive symptoms among middle-aged women in Canada.”

In a cross-sectional study, Shea and colleagues analyzed data on menopausal status, use of HT and other sociodemographic and lifestyle variables from 13,216 women aged 45 to 64 years who participated in the Canadian Longitudinal Study on Aging between 2010 and 2015. Menopause occurring before age 40 years was considered premature onset; aged 40 to 45 years was considered early onset; aged 46 to 55 years, normal onset; and aged at least 56 years, late onset. Depressive symptoms were measured using the 10-item Center for Epidemiologic Studies Short Depression Scale; a score between 10 and 30 on the scale indicates depression.

Researchers identified 18.1% of participants as depressed with a median depression score of 12.1. Compared with participants with depression, those without depression were more likely to have higher levels of education and income, to be married or partnered, to have children and social support, to not have obesity and to be nonsmokers.

The average age at menopause was approximately 49 years; 402 participants reported premature menopause, 1,232 reported early menopause, 6,704 reported normal menopause and 576 reported late-onset menopause. In models adjusted for sociodemographic variables, only premature menopause compared with normal menopause was associated with scores indicating depression (adjusted OR = 1.45; 95% CI, 1.07-1.97). Current use of HT (n = 1,318) vs. no current use was also associated with depression (aOR = 1.21; 95% CI, 1.02-1.44).

“Premature menopause and current use of HT were both associated with increased odd of having current depression after adjustment for other covariates,” Shea and colleagues wrote. “Given that the menopausal transition is a vulnerable time for mental health, the identification of risk factors, including social determinants of health, age at menopause and menopausal symptoms, can help guide clinicians when assessing mental health.” – by Kate Burba

Disclosures: Shea reports she received honorarium from Pfizer. Please see the study for all other authors’ relevant financial disclosures.