High Rates of Depression in Perimenopause Explained

July 9, 2014

Perimenopause is a period of high risk for first-time depression. Why? Probably because levels of monoamine oxidase A (MAO-A), a brain enzyme, are elevated.

[[{"type":"media","view_mode":"media_crop","fid":"25654","attributes":{"alt":"","class":"media-image media-image-right","id":"media_crop_8477614489383","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"2382","media_crop_rotate":"0","media_crop_scale_h":"107","media_crop_scale_w":"160","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"line-height: 1.538em; float: right;","title":" ","typeof":"foaf:Image"}}]]Perimenopause is a period of high risk for mood disorders, and new research may have discovered why. It has recently been discovered that a brain protein linked to depression is more abundant in perimenopausal women than it is in either younger women or those who have already reached menopause.

Scientists responsible for the finding believe it may explain high first-time depression rates in perimenopausal women as well as mood changes among women going through the transition into menopause.

Pertinent Points

- Elevated levels of the brain protein MAO-A may help explain the increased rates in depression among women in perimenopause.

- Having identified the biological change, researchers are now aiming to study ways to prevent the change, including looking at dietary supplements and beginning estrogen replacement therapy at earlier stages.

"This is the first time that a biological change in the brain has been identified in perimenopause which is also associated with clinical depression," said Jeffrey Meyer, PhD, of the Centre for Addiction and Mental Health at Campbell Family Mental Health Research Institute in Toronto, Canada.

Meyer and his research team found elevated levels of the enzyme monoamine oxidase A (MAO-A) among women aged 41 to 51 years. The findings were published in June in JAMA Psychiatry.

High levels of MAO-A, the enzyme that breaks down serotonin, norepinephrine, and dopamine, has previously been linked to major depressive disorder and postpartum depression, Meyer said.

The study looked at 58 women who agreed to a positron emission tomography (PET) scan. Among the women, 19 were of reproductive age, 27 were in perimenopause, and 12 were in menopause. On average, the researchers found that levels of MAO-A in perimenopausal women were 34% higher than in younger women and 16% higher than in menopausal women.

Next, Meyer said he hopes to test possible ways to prevent the elevation of MAO-A. One possibility may be the use of dietary supplements, which Meyer said he is already testing in a separate study aimed at postpartum women. Hormone replacement therapy at earlier stages is another possibility, because following declines in estrogen levels, MAO-A can be elevated for a month or longer, he said.