Menopausal depression takes a huge toll, but is underfunded and under-researched — that needs to change.
. Yet there remains considerable reluctance to use them; in many cases, a diagnosis of any form of depression still leads to an automatic prescription of an antidepressant. This practice is particularly inexplicable given that the guidelines from both the North American Menopause Society and the International Menopause Society highlight the safety of hormone therapy in women during and up to 10 years after menopause.
There was a clear starting point for this automatic jump to antidepressants. In the early 2000s, a studyby the Women’s Health Initiative on hormone replacement therapy during menopause received sensational media attention. In 2002, the investigators suddenly stopped the combined HRT arm of the study because of an increased risk of breast cancer, heart disease, stroke and blood clots.
Improving outcomes for people with menopause-related depression requires some significant changes. Most importantly, psychiatrists and other mental-health practitioners who treat women in their 40s and 50s need to enquire about menopause at the outset of treatment, and be willing to prescribe hormone therapies. In addition, clinicians and health-care students alike need to be better educated about this phase of women’s lives.
To educate the public as well as health-care workers, we need the term menopausal depression to be recognized as a diagnostic entity. And more funding needs to be directed into women’s mental-health care. The treatment of depression in middle-aged women, who are often key senior employees as well as the main carers for both young and older people, needs to be made a higher priority.
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