First Ever Guidelines for Perimenopausal Depression Released

A group convened by The North American Menopause Society and the National Network on Depression Centers Women and Mood Disorder Task Group and endorsed by the International Menopause Society have published the first-ever guidelines for the evaluation and treatment of perimenopausal depression.


“There is a new appreciation of the perimenopause—defined as the early and late menopause transition stages as well as the early postmenopause—as a window of vulnerability for the development of both depressive symptoms and major depressive episodes. However, clinical recommendations on how to identify, characterize and treat clinical depression are lacking,” the authors wrote.


The guidelines address 5 areas: epidemiology; clinical presentation; therapeutic effects of antidepressants; effects of hormone therapy; and efficacy of other therapies.


Among the recommendations:

  • When selecting antidepressants during perimenopause, a woman’s prior history of antidepressant use should be considered.
  • Cooccurring sleep disturbances and night sweats should be considered as part of treatment for menopause-related depression.
  • While estrogen-based therapies may help improve clinical response to antidepressants, their use in older women should be considered with caution.

—Michael Potts


Maki PM, Kornstein SG, Joffe H, et al. Guidelines for the evaluation and treatment of perimenopausal depression: summary and recommendations [published online September 5, 2018]. Journal of Women’s Health.