This is because there is no evidence that they actually help psychological symptoms of the menopause. Despite this clear recommendation, many women are inappropriately offered antidepressants when they first seek help from a healthcare professional about their menopausal symptoms.

Antidepressants, such as citalopram or venlafaxine in low doses, are sometimes prescribed to help with hot flushes and night sweats for women who cannot take HRT as a firstline treatment.

For some women, these medications can help to reduce these symptoms, but they are not usually effective in helping their mood related changes or other menopausal symptoms such as vaginal dryness, headaches and joint pains as these are due to fluctuating or lowered levels of estrogen and testosterone.

Because mood changes during the perimenopause and menopause are caused by altered hormones, the most effective treatment is to stabilise hormone levels by taking replacement estrogen and for some women, testosterone as well.

The right dose and type of estrogen can really help improve low mood and other psychological symptoms related to the menopause. Many women find that they feel calmer, their motivation and interest in things returns, along with a greater sense of energy, and they are generally much happier after a few months of being on HRT.

There will usually be an improvement in other menopausal symptoms as well, such as hot flushes and night sweats, insomnia, vaginal dryness and many other symptoms. Research has shown that if women are given HRT when they are perimenopausal, this can reduce the incidence of clinical depression developing.

Many women who start HRT and have been incorrectly given antidepressants in the past, find that their depressive symptoms improve on the right dose and type of HRT, to the extent that they can reduce and often stop taking their antidepressants.

For most women experiencing low mood, anxiety, irritability, or mood swings, it is a combination of approaches that works best. There are lifestyle factors that can really help you feel better and on a more even keel. Eating healthily with lots of fruits and vegetables and limiting overly processed foods, excess salt and sugar and white refined carbohydrates, can be beneficial.

Foods high in essential fats such as Omega 3 oils, and those rich in B vitamins, calcium and vitamin D can also help improve your mood. Taking exercise regularly, such as swimming, brisk walking, jogging or an exercise class, boosts endorphins — hormones that relieve pain and reduce stress — as can activities such as yoga and tai chi.

Talking therapy such as cognitive behavioural therapy CBT has been shown to help with menopausal low mood and anxiety, and interestingly, even physical symptoms such as hot flushes.

Despite their name, antidepressants can treat a variety of conditions besides depression. These include:. Antidepressants may also help treat menopause symptoms. Read on to learn more about the benefits of antidepressants for menopause.

Antidepressants may provide relief from vasomotor symptoms of menopause. Vasomotor symptoms involve the blood vessels. They include things like:. These are also some of the most common menopause symptoms. Almost 80 percent of menopausal women experience these symptoms, notes a study. Studies suggest that low doses of SSRIs or SNRIs may help reduce vasomotor symptoms, especially hot flashes and night sweats.

For example, a clinical trial found that a low dose of the SNRI venlafaxine Effexor worked almost as well as traditional hormone therapy for reducing hot flashes. Another clinical trial from found that a low dose of the SSRI paroxetine Paxil improved sleep quality in women going through menopause.

It may be related to their ability to balance norepinephrine and serotonin levels. Keep in mind that antidepressants are only known to help with hot flashes and night sweats.

Antidepressants can cause a range of side effects. SSRIs generally cause the fewest side effects. Your doctor might suggest trying this type first. Tricyclic antidepressants, including amitriptyline , can cause additional side effects, such as:.

Antidepressant side effects also vary between medications, even within the same type of antidepressant. Work with your doctor to choose an antidepressant that provides the most benefit with the fewest side effects. You might have to try a few before you find one that works.

Antidepressants are generally safe. However, most antidepressants used for menopause symptoms are considered off-label use. Effect of desvenlafaxine on mood and climacteric symptoms in menopausal women with moderate to severe vasomotor symptoms.

Suvanto-Luukkonen, E. Citalopram and fluoxetine in the treatment of postmenopausal symptoms: a prospective, randomized, 9-month, placebo-controlled, double-blind study.

Menopause 12 , 18—26 Moher, D. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. Yasui, T. Changes in circulating cytokine levels in midlife women with psychological symptoms with selective serotonin reuptake inhibitor and Japanese traditional medicine.

Higgins, J. Cochrane Handbook for Systematic Reviews of Interventions version 6. Cochrane , Available from www. Borenstein, M. A basic introduction to fixed-effect and random-effects models for meta-analysis.

Quantifying heterogeneity in a meta-analysis. Basics of meta-analysis: I2 is not an absolute measure of heterogeneity. In: Higgins JP, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions. Egger, M. Bias in meta-analysis detected by a simple, graphical test.

Duval, S. Trim and fill: A simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics 56 , — Article CAS Google Scholar. Tobias, A. Assessing the influence of a single study in meta-analysis. Stata Tech. Google Scholar. Davey, J. Characteristics of meta-analyses and their component studies in the Cochrane Database of Systematic Reviews: a cross-sectional, descriptive analysis.

BMC Med. Davari-Tanha, F. Kornstein, S. Short-term efficacy and safety of desvenlafaxine in a randomized, placebo-controlled study of perimenopausal and postmenopausal women with major depressive disorder.

Paroxetine versus placebo for women in midlife after hormone therapy discontinuation. Bromberger, J. Patterns of depressive disorders across 13 years and their determinants among midlife women: SWAN mental health study. Depressive symptoms across the menopause transition: findings from a large population-based cohort study.

Carvalho, A. The Safety, Tolerability and Risks Associated with the Use of Newer Generation Antidepressant Drugs: A Critical Review of the Literature. Fava, G. Rational use of antidepressant drugs.

Nonhormonal management of menopause-associated vasomotor symptoms: position statement of The North American Menopause Society. Download references. WinShine Clinics in Specialty of Psychiatry, Kaohsiung City, Taiwan.

Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan. Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan. Department of Psychiatry, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan. Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.

School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan. Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK.

Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK. Department of Psychiatry, University of Toronto, Toronto, ON, Canada.

Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan. Department of Emergency Medicine, E-Da Hospital, Kaohsiung, Taiwan.

Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan. Department of Chemical Engineering and Institute of Biotechnology and Chemical Engineering, I-Shou University, Kaohsiung, Taiwan.

Institute of Medical Science and Technology, National Sun Yat-sen University, Kaohsiung, Taiwan. You can also search for this author in PubMed Google Scholar. and M. W contributed equally as first authors and conceived the study. and P. all contributed to study design and literature review.

and Y. were responsible for data analysis. wrote the draft of the manuscript. and C. both contributed as corresponding authors and took responsibility for revising and submitting the manuscript. Correspondence to Yu-Shian Cheng or Cheuk-Kwan Sun.

The original online version of this Article was revised: The original version of this Article contained errors. Additionally, the study protocol is reported in detail in the Methods section of the Article.

Open Access This article is licensed under a Creative Commons Attribution 4. Reprints and permissions. Wu, CK. Antidepressants during and after Menopausal Transition: A Systematic Review and Meta-Analysis.

Sci Rep 10 , Download citation. Received : 23 September Accepted : 19 March Published : 15 May Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative.

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Download PDF. Subjects Health care Medical research Psychiatric disorders. This article has been updated. Abstract To assess the therapeutic benefits of antidepressants in depressive women during and after menopausal transition, PubMed, Cochrane Library, EMBASE and Science Direct were systematically searched from inception to February 1, for randomized controlled trials examining antidepressants compared to placebo.

Introduction Accumulating evidence indicates that women appear to be at a particularly higher risk of the emergence of major depressive disorder MDD and also depressive symptoms not severe enough to meet the diagnostic criteria of MDD during menopausal transition 1. Methods Guidelines and protocol This systematic review and meta-analysis was conducted according to the guidelines presented in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses PRISMA statement 18 Supplementary Table S1.

Eligibility criteria The inclusion criteria were: 1 peer-reviewed articles investigating the efficacy of antidepressants on depressive symptoms in menopausal women meeting the criteria for MDD or experiencing subthreshold depressive symptoms; and 2 articles that were controlled trials conducted in humans.

Methodological quality appraisal Two independent authors YS Cheng and PT Tseng evaluated the risk of bias inter-rater reliability, 0. Primary outcome The primary outcome measure was a change in the severity of depressive symptoms as rated by standard instruments used in each included study.

Secondary outcomes Secondary outcomes of interest included response and remission rates in each group. Data extraction and management Two independent authors extracted data from the eligible studies into a database of pre-determined variables of interest, including mean age years , mean body mass index BMI , duration of antidepressant treatment weeks , and ethnicity Caucasian, African American, Hispanic, or Asian.

Statistical analysis Based on the presumed high heterogeneity among the included studies, data were analyzed using random-effects meta-analysis models rather than fixed effects models 21 using Comprehensive Meta-Analysis software version 3 Biostat, Englewood, NJ.

Results Study selection The PRISMA flowchart used for study selection in this systematic review is shown in Fig. Figure 1. Flowchart of the Current Systematic Review and Meta-analysis. Full size image.

Table 1 Summary of characteristics of studies in the current meta-analysis. Full size table. Figure 2. Figure 3. Figure 4. Figure 5.

These include:. Antidepressants may also help treat menopause symptoms. Read on to learn more about the benefits of antidepressants for menopause. Antidepressants may provide relief from vasomotor symptoms of menopause.

Vasomotor symptoms involve the blood vessels. They include things like:. These are also some of the most common menopause symptoms.

Almost 80 percent of menopausal women experience these symptoms, notes a study. Studies suggest that low doses of SSRIs or SNRIs may help reduce vasomotor symptoms, especially hot flashes and night sweats. For example, a clinical trial found that a low dose of the SNRI venlafaxine Effexor worked almost as well as traditional hormone therapy for reducing hot flashes.

Another clinical trial from found that a low dose of the SSRI paroxetine Paxil improved sleep quality in women going through menopause. It may be related to their ability to balance norepinephrine and serotonin levels. Keep in mind that antidepressants are only known to help with hot flashes and night sweats.

Antidepressants can cause a range of side effects. SSRIs generally cause the fewest side effects. Your doctor might suggest trying this type first. Tricyclic antidepressants, including amitriptyline , can cause additional side effects, such as:.

Antidepressant side effects also vary between medications, even within the same type of antidepressant. Work with your doctor to choose an antidepressant that provides the most benefit with the fewest side effects. You might have to try a few before you find one that works.

Antidepressants are generally safe. However, most antidepressants used for menopause symptoms are considered off-label use. Food and Drug Administration FDA specifically to treat vasomotor symptoms. Antidepressants can also interact with other medications, so make sure to tell your doctor about all over-the-counter and prescription medication you take.

This includes vitamins and supplements as well. Your doctor can help you weigh the benefits and risks of using antidepressants for menopause symptoms. Serotonin syndrome is a rare but serious condition that happens when your serotonin levels are too high.

It tends to happen when you use antidepressants, especially MAOIs, with other medications, supplements, or illicit drugs that increase your serotonin levels. Seek emergency medical treatment if you experience any of these side effects while taking antidepressants:.

Treating hot flashes and night sweats is one of the more popular off-label uses of some antidepressants. Recently, the FDA approved the use of Brisdelle for these symptoms.

Low doses of antidepressants often cause fewer side effects and reduce certain risks of hormone therapy. However, antidepressants only help with certain menopause symptoms. Work with your doctor to figure out the most effective treatment option for your symptoms.

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. This is particularly relevant because cross-sectional and prospective studies have indicated that depressive symptoms in this population appear to occur on a continuum of severity 14 , 32 , Moreover, subthreshold depression may significantly impair the quality of life and functioning of this population 14 , which may also increase the risk of MDD in a subset of women during or after menopausal transition 32 , Furthermore, most of the studies seemed to have fair quality, while there was only dominant unclear risk in the item of allocation concealment.

However, most of the studies were conducted in North America, with only one from the Middle East 29 and one from North Europe Therefore, extrapolation of the results to other populations may not be justified.

In addition, treatment with antidepressants was associated with a higher likelihood of achieving response and remission relative to a placebo. However, there was evidence of publication bias on the overall effects of antidepressants on treatment response, and hence the results should be interpreted with caution since this effect was rendered non-significant following adjustments for publication bias.

It is also worth noting that only three trials provided data regarding response and remission rates. Moreover, as in most meta-analyses, another limitation of the current study was the heterogeneity of the included studies in terms of study duration, drug dosage, the use of different depression scales and different versions e.

Therefore, we performed subgroup analysis and meta-regression to investigate how different factors may affect the study results. Meta-regression showed that certain factors such as duration and age did not affect our results, and our subgroup analysis demonstrated that antidepressant treatment was still effective for those suffering from subthreshold depression.

Nevertheless, the number of studies was too small to allow other meaningful subgrouping or meta-regression analyses. Besides, there was heterogeneity in some estimates, the sources of which were explored through subgroup and meta-regression analyses. However, due to the relatively small number of studies, the results from these analyses should be regarded as exploratory instead of conclusive.

Furthermore, in recent years, perimenopausal depression is considered a distinct subtype of depression that warrants a unique rating scale for evaluation 3.

Nevertheless, most studies in the present meta-analysis were old and did not use criteria specified for perimenopausal depression 3. The issue was further complicated by the fact that most studies included a mixed population of women during menopausal transition and in the postmenopausal phase.

Therefore, whether the instruments reported in those studies could capture the complex symptoms of perimenopausal depression remains to be elucidated.

Finally, the overall body of evidence remains limited in this area. Because the treatment of depression during menopause remains a clinical challenge, the findings of the present study had its clinical implications.

The current meta-analysis indicates that antidepressants could be efficacious for the treatment of this condition in this vulnerability period of the female reproductive cycle.

However, only three RCTs included participants with a definite diagnosis of MDD 11 , 12 , An evidence-based psychotherapeutic approach for depression e. Interestingly, we did not identify any RCTs on the effects of tricyclic antidepressant agents in postmenopausal women with depression.

Therefore, this meta-analysis provides evidence for the use of SSRIs and SNRIs as treatments for depression in this population. Specifically, the antidepressants fluoxetine 12 , 17 , citalopram 17 , 29 , paroxetine 31 , desvenlafaxine 11 , 16 , 30 and venlafaxine 29 were tested across the included RCTs.

Further research is warranted to investigate the effects of other antidepressants in this population. There was no significant difference in dropout rate between the participants treated with antidepressants and those who received a placebo. However, antidepressant treatment was associated with a greater likelihood of discontinuation due to adverse events.

This is consistent with an increasing number of studies that have raised concerns regarding the safety and tolerability of newer generation antidepressants, including SSRIs and SNRIs Such concerns should be weighed when considering the use of antidepressants, especially for women during or after menopausal transition with less severe forms of depression The current systematic review and meta-analysis may provide new directions for research.

First, only acute antidepressant trials were identified. However, depressive disorders in postmenopausal women appear to have heterogenous symptom trajectories 32 , 33 , and further investigations are warranted to investigate the benefits of maintenance treatment with antidepressants for depressive disorders in this population i.

In addition, our subgroup analysis suggested that SNRIs but not SSRIs were associated with higher discontinuation rates due to adverse events relative to a placebo.

However, further RCTs are needed to confirm this finding. It has been suggested that the presence of vasomotor symptoms during menopause may contribute to the development and persistence of depressive disorders during this phase of the female reproductive cycle 14 , and also that low-dose paroxetine and SNRIs could improve these symptoms Therefore, further research is needed to investigate whether the amelioration of vasomotor disturbances could contribute to the beneficial effects of antidepressants seen in the current study.

Finally, the evidence base regarding options for the treatment of depressive disorders during menopause remains limited. The design of new RCTs is a necessary step before firm conclusions regarding the comparative efficacy and tolerability of various pharmacological treatments can be made.

The current systematic review and meta-analysis provides evidence that antidepressants are effective for the treatment of depressive disorders for women during and after menopausal transition. Long-term RCTs are required to investigate the efficacy, safety, and tolerability of maintenance treatment with antidepressants during menopause.

Yu-Shian Cheng Y. and Ping-Tao Tseng Y. both had full access to all the data in this study, conducted the data analysis, and took responsibility for integrity of the data and accuracy of the data analysis.

The data of the current study are available within the article and its supplementary materials. For further information, requests shall be directed to the corresponding author. Georgakis, M. et al. Association of age at menopause and duration of reproductive period with depression after menopause: A systematic review and meta-analysis.

Article PubMed Google Scholar. Soules, M. Executive summary: Stages of Reproductive Aging Workshop STRAW. Article CAS PubMed Google Scholar. Kulkarni, J. Development and validation of a new rating scale for perimenopausal depression-the Meno-D.

Article PubMed PubMed Central Google Scholar. Nazarpour, S. Factors affecting sexual function in menopause: A review article. Baker, F. Sleep problems during the menopausal transition: prevalence, impact, and management challenges. S Bungay, G. Study of symptoms in middle life with special reference to the menopause.

Article CAS PubMed PubMed Central Google Scholar. Stuenkel, C. Treatment of symptoms of the menopause: An Endocrine Society Clinical Practice Guideline. Whedon, J. Bioidentical estrogen for menopausal depressive symptoms: A systematic review and meta-analysis.

Article Google Scholar. Rossouw, J. Ness, J. Menopausal symptoms after cessation of hormone replacement therapy. Clayton, A. Macias-Cortes Edel, C. Individualized homeopathic treatment and fluoxetine for moderate to severe depression in peri- and postmenopausal women HOMDEP-MENOP study : a randomized, double-dummy, double-blind, placebo-controlled trial.

Vivian-Taylor, J. Menopause and depression: is there a link? Maturitas 79 , — Soares, C. Depression and Menopause: Current Knowledge and Clinical Recommendations for a Critical Window.

Maki, P. Guidelines for the evaluation and treatment of perimenopausal depression: summary and recommendations. Cheng, R. Effect of desvenlafaxine on mood and climacteric symptoms in menopausal women with moderate to severe vasomotor symptoms. Suvanto-Luukkonen, E.

Citalopram and fluoxetine in the treatment of postmenopausal symptoms: a prospective, randomized, 9-month, placebo-controlled, double-blind study. Menopause 12 , 18—26 Moher, D. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.

PLoS Med. Yasui, T. Changes in circulating cytokine levels in midlife women with psychological symptoms with selective serotonin reuptake inhibitor and Japanese traditional medicine.

Higgins, J. Cochrane Handbook for Systematic Reviews of Interventions version 6. Cochrane , Available from www. Borenstein, M. A basic introduction to fixed-effect and random-effects models for meta-analysis. Quantifying heterogeneity in a meta-analysis. Basics of meta-analysis: I2 is not an absolute measure of heterogeneity.

In: Higgins JP, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions. Egger, M. Bias in meta-analysis detected by a simple, graphical test. Duval, S. Trim and fill: A simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis.

Biometrics 56 , — Article CAS Google Scholar. Tobias, A. Assessing the influence of a single study in meta-analysis. Stata Tech. Google Scholar. Davey, J. Characteristics of meta-analyses and their component studies in the Cochrane Database of Systematic Reviews: a cross-sectional, descriptive analysis.

BMC Med. Davari-Tanha, F. Kornstein, S. Short-term efficacy and safety of desvenlafaxine in a randomized, placebo-controlled study of perimenopausal and postmenopausal women with major depressive disorder. Paroxetine versus placebo for women in midlife after hormone therapy discontinuation.

Bromberger, J. Patterns of depressive disorders across 13 years and their determinants among midlife women: SWAN mental health study.

Depressive symptoms across the menopause transition: findings from a large population-based cohort study. Carvalho, A. The Safety, Tolerability and Risks Associated with the Use of Newer Generation Antidepressant Drugs: A Critical Review of the Literature. Fava, G. Rational use of antidepressant drugs.

Nonhormonal management of menopause-associated vasomotor symptoms: position statement of The North American Menopause Society.

Download references. WinShine Clinics in Specialty of Psychiatry, Kaohsiung City, Taiwan. Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan. Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan. Department of Psychiatry, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan.

Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan. School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan. Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK. Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK.

Department of Psychiatry, University of Toronto, Toronto, ON, Canada. Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.

Department of Emergency Medicine, E-Da Hospital, Kaohsiung, Taiwan. Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan.

Department of Chemical Engineering and Institute of Biotechnology and Chemical Engineering, I-Shou University, Kaohsiung, Taiwan. Institute of Medical Science and Technology, National Sun Yat-sen University, Kaohsiung, Taiwan.

You can also search for this author in PubMed Google Scholar. and M. W contributed equally as first authors and conceived the study. and P. all contributed to study design and literature review. and Y. were responsible for data analysis. wrote the draft of the manuscript. and C. both contributed as corresponding authors and took responsibility for revising and submitting the manuscript.

Correspondence to Yu-Shian Cheng or Cheuk-Kwan Sun. The original online version of this Article was revised: The original version of this Article contained errors. Additionally, the study protocol is reported in detail in the Methods section of the Article.

Open Access This article is licensed under a Creative Commons Attribution 4. Reprints and permissions. Wu, CK. Antidepressants during and after Menopausal Transition: A Systematic Review and Meta-Analysis.

Sci Rep 10 , Download citation. Received : 23 September Accepted : 19 March Published : 15 May Anyone you share the following link with will be able to read this content:.

Sorry, a shareable link is not currently available for this article.

Many women find that they feel calmer, their motivation and interest in things returns, along with a greater sense of energy, and they are generally much happier after a few months of being on HRT.

There will usually be an improvement in other menopausal symptoms as well, such as hot flushes and night sweats, insomnia, vaginal dryness and many other symptoms.

Research has shown that if women are given HRT when they are perimenopausal, this can reduce the incidence of clinical depression developing. Many women who start HRT and have been incorrectly given antidepressants in the past, find that their depressive symptoms improve on the right dose and type of HRT, to the extent that they can reduce and often stop taking their antidepressants.

For most women experiencing low mood, anxiety, irritability, or mood swings, it is a combination of approaches that works best. There are lifestyle factors that can really help you feel better and on a more even keel.

Eating healthily with lots of fruits and vegetables and limiting overly processed foods, excess salt and sugar and white refined carbohydrates, can be beneficial.

Foods high in essential fats such as Omega 3 oils, and those rich in B vitamins, calcium and vitamin D can also help improve your mood. Taking exercise regularly, such as swimming, brisk walking, jogging or an exercise class, boosts endorphins — hormones that relieve pain and reduce stress — as can activities such as yoga and tai chi.

Talking therapy such as cognitive behavioural therapy CBT has been shown to help with menopausal low mood and anxiety, and interestingly, even physical symptoms such as hot flushes.

These alternative treatments are even more important for women who do not wish to, or cannot take, HRT. If you have not had episodes of depression in the past and have now been prescribed antidepressants for your low mood or anxiety associated with your menopause or perimenopause, consider whether this is the right treatment for you.

It is worth seeing a doctor who specialises in the menopause for individualised advice. Feb 7. Feb 3. Feb 1. This content does not have an English version. This content does not have an Arabic version. Diagnosis Perimenopause is a process — a gradual transition. Care at Mayo Clinic Our caring team of Mayo Clinic experts can help you with your perimenopause-related health concerns Start Here.

More Information Perimenopause care at Mayo Clinic Endometrial ablation. Request an appointment. By Mayo Clinic Staff. Show references Lobo RA, et al. Menopause and care of the mature woman: Endocrinology, consequences of estrogen deficiency, effects of hormone therapy, and other treatment options.

In: Comprehensive Gynecology. Elsevier; Accessed March 5, Menopausal hormone therapy adult. Mayo Clinic; Bioidentical hormones. Natural Medicines. Black cohosh. Ferri FF. In: Ferri's Clinical Advisor Menopausal symptoms: In depth.

National Center for Complementary and Integrative Health. Delamater L, et al. Management of the perimenopause. Clinical Obstetrics and Gynecology. Suss H, et al. Psychological resilience during the perimenopause. Raglan GB, et al. Depression during perimenopause: The role of the obstetrician-gynecologist.

Archives of Women's Mental Health. Bacon JL. The menopausal transition. Obstetrics and Gynecology Clinics of North America. Top questions about menopause. Office on Women's Health. Warner KJ. Allscripts EPSi.

Mayo Clinic. Johnson A, et al. Complementary and alternative medicine for menopause. Journal of Evidence-Based Integrative Medicine. Minkin MJ. Menopause: Hormones, lifestyle, and optimizing aging.

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Barton DL, LaVasseur BI, Sloan JA, et al. Phase III, placebo-controlled trial of three doses of citalopram for the treatment of hot flashes: NCCTG trial N05C9.

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Suvanto-Luukkonen E, Koivunen R, Sundström H, et al. Citalopram and fluoxetine in the treatment of postmenopausal symptoms: a prospective, randomized, 9-month, placebo-controlled, double-blind study. Speroff L, Gass M, Constantine G, Olivier S for the Study Investigators.

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Archer DF, Dupont CM, Constantine GD, Pickar JH, Olivier S for the Study Investigators. Desvenlafaxine for the treatment of vasomotor symptoms associated with menopause: a double-blind, randomized, placebo-controlled trial of efficacy and safety.

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for the Study Investigators.