Revista Contemporânea · Aug 26, 2026
Perimenopause and depression: A review of risk factors, diagnosis, and therapeutic approach
By Dantas N
Perimenopause represents a period of significant biological transition in a woman's life, characterized by changes in ovarian function, menstrual irregularity, and substantial fluctuations in sex hormones, especially estradiol. In addition to vasomotor and genitourinary symptoms, this phase may be associated with sleep changes, anxiety, irritability, reduced concentration, and depressive symptoms. Epidemiological evidence demonstrates that the menopausal transition constitutes a window of increased vulnerability to the development of depressive symptoms and episodes of major depression. The etiology is multifactorial and involves the interaction between hormonal fluctuations, neurobiological changes, physical symptoms, sleep disorders, stressful events, and a prior history of mood disorders. Diagnosis should be clinical and treatment individualized, potentially including psychotherapy, antidepressants, sleep and lifestyle interventions, and, in selected patients, menopausal hormone therapy. An integrated approach involving psychiatry, gynecology, and primary care is essential for the early recognition and appropriate treatment of depression during the menopausal transition.