A recent study utilizing data from the UK Biobank has uncovered that perimenopause significantly increases the risk of developing psychiatric disorders, particularly major depressive disorder and mania. Perimenopause, the transitional period leading up to menopause, is marked by fluctuating hormone levels as the ovaries gradually cease functioning.
The study analyzed data from 128,294 female participants, comparing the incidence rates of psychiatric disorders during the perimenopausal period to those in the premenopausal and postmenopausal periods. It found that:
Increased Risk During Perimenopause: The incidence rates of first-onset psychiatric disorders were notably higher during perimenopause compared to premenopause, with major depressive disorder and mania showing the most significant increases. Specifically, the rate of mania was more than twice as high during perimenopause compared to premenopause, although it returned to premenopausal levels postmenopause. Major depressive disorder also saw increased rates during perimenopause, which remained elevated but slightly reduced in postmenopause.
No Significant Change in Schizophrenia Spectrum Disorders: The study did not find a significant increase in the risk of schizophrenia spectrum disorders during perimenopause, contrary to some previous theories about hormonal changes influencing this condition.
Other Psychiatric Disorders: Increased incidence rates of anxiety, panic attacks, substance abuse, PTSD, eating disorders, stress, OCD, and insomnia were observed during both perimenopause and postmenopause.
The research highlights the need for clinicians to be aware of the heightened risk of psychiatric conditions during perimenopause and not to solely attribute new psychiatric symptoms to hormonal changes. Adjustments for various confounding factors, including socio-economic status, physical health, and lifestyle, did not alter the observed associations, except for underweight participants and current smokers where the association was less clear.
The findings underscore the importance of accurate diagnostic practices and suggest future research should involve large cohorts with prior mental health histories to better understand and address the impacts of reproductive aging on mental health.