Depression and Its Influence on Reproductive Endocrine and Menstrual Cycle Markers Associated With Perimenopause

Bernard L. Harlow, Lauren A. Wise, Michael W. Otto, Cláudio N. Soares, Lee S. Cohen
In: Archives of General Psychiatry · 2003 · vol. 60(1) , pp. 29 · doi:10.1001/archpsyc.60.1.29 · PMID:12511170 · W1979243202
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Women with a lifetime history of depression exhibited accelerated perimenopause, higher FSH/LH, and lower estradiol levels, suggesting an association with earlier ovarian function decline.

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Abstract

BACKGROUND: Few studies have determined the impact of a lifetime history of major depression on an early transition to menopause. METHODS: Reproductive and psychiatric interviews and early follicular-phase blood specimens were obtained at study enrollment and every 6 months during 36 months of follow-up from 332 women with and 644 women without a history of major depression, 36 to 45 years of age. We used menstrual cycle markers to determine inception of perimenopause, defined as time from study enrollment to a follow-up interview with: (1) 7-day or more change in menstrual cycle length; (2) a change in menstrual flow amount or duration; or (3) amenorrhea lasting at least 3 months. RESULTS: Women with a history of depression had 1.2 times the rate of perimenopause of women with no such history (95% confidence interval, 0.9-1.6). Compared with nondepressed women, depressed women with more pronounced depressive symptoms at study enrollment (Hamilton Rating Scale for Depression scores >8) had twice the risk of an earlier perimenopausal transition. Among the women with greater depressive symptoms (Hamilton scores >8), those who also reported use of antidepressants had nearly 3 times the risk of an earlier perimenopausal transition (hazard ratio, 2.7; 95% confidence interval, 1.5-4.8) of nondepressed women. Women with a lifetime history of depression also had higher follicle-stimulating hormone and luteinizing hormone levels and lower estradiol levels at study enrollment and during the follow-up period after adjustment for covariates. CONCLUSION: A lifetime history of major depression may be associated with an early decline in ovarian function.

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