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Ask An Expert

Best Treatment for Menopausal Depression

Toni J. Brayer

Toni J. Brayer, M.D.

Sutter Pacific Medical Foundation

California Pacific Medical Center

Question:

What is the more appropriate way to treat menopausal depression, hormone replacement or SSRIs?

Answer:

There is no one answer to treating "menopausal depression". Restoring hormones (HRT) and SSRI antidepressants have both been shown to help with depression in mid-life women. There are other things that have also been proven to help.

Many women experiencing menopause have sleep disturbance. Lack of sleep leads to mood disorders and getting good, restful sleep is critical for good mental health. In some studies, exercise has proven as beneficial as antidepressant pills. Exercise also helps with sleep and increases energy levels, so the effects are additive. Even being in sunlight can improve mood and serotonin in the brain. Serotonin levels play a major role in depression and there can be genetic causes for low serotonin. The combination of declining hormones with low serotonin can be a double whammy for women in menopause. Every woman is different and treatment must be individualized.

Depression in menopause, like any depression, can be treated effectively. Treatment with these complicated medicines should be decided between you and your physician.

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