The perimenopause and affective disorders.

A variety of epidemiologic studies have identified that the majority of postmenopausal women do not experience a depression during the perimenopause. In contrast, results of several epidemiologic studies and clinic-based surveys suggest that a substantial number of perimenopausal women, in fact, do experience a clinically significant depression. In this article, we review these studies. Case examples are described to introduce a discussion of the characteristics of perimenopause-related depression, and we identify several factors occurring during midlife in women that may potentially contribute to mood dysregulation at this time. Finally, we provide suggestions for the evaluation and management of women presenting with perimenopause-related depression.