The role of depressive symptomatology in peri- and post-menopause

Objectives There is evidence that menopausal symptoms manifested at peri-menopause occur less frequently when compared to the symptoms experienced at post-menopause. The aim of this study was to investigate this and to test the hypothesis that depressive symptomatology mediates the relationship between menopausal stage and symptom frequency. Methods This cross-sectional study included 213 women (M age = 52 years), of whom 125 were peri- and 88 post-menopausal. Measures comprised the Center for Epidemiologic Studies-Depression scale (CES-D) and the Women's Health Questionnaire (WHQ) vasomotor symptoms and somatic symptoms subscales. Results Multiple mediated regression analyses provided evidence that somatic symptoms and vasomotor symptoms were less frequent at post- compared to peri-menopause, and that these differences were mediated by depressive symptomatology. Multivariate effect sizes ranged from small to moderate, and univariate effect sizes were uniformly small with wide confidence intervals. Conclusions The frequency of vasomotor and somatic symptoms appears to increase with depressed affect. The management of symptoms could include interventions of a psychotherapeutic nature, which may offset this effect, particularly in women for whom depressive symptoms are a feature of the climacteric syndrome. The extent to which depression and the climacteric syndrome may be causally related to one another remains unclear and longitudinal research should further examine the mechanisms of this association.