Epidemiology of depression throughout the female life cycle.

Women are at an increased risk for first onset of major depression from early adolescence until their mid-50s and have a lifetime rate of major depression 1.7 to 2.7 times greater than that for men. There is accumulating evidence that certain reproductive-related hormonal changes place women at increased risk for depression. For example, puberty marks the beginning of increased risk for depression in women. Most women report physical or emotional symptoms premenstrually, with some severe enough to be diagnosed as premenstrual dysphoric disorder. While pregnancy does not increase the risk for depression, women with past histories of depression are at risk for recurrent episodes or relapse if antidepressant medications are discontinued. Hormonal changes during the postpartum period also increase the incidence of depression. Similarly, women transitioning through perimenopause, particularly those with past psychiatric histories, report depressive symptoms. Prophylaxis and treatment to minimize severity in cases of recurrence are discussed in the article, using reproductive transitional events as markers.