Association of lifespan reproductive duration with depression in Swedish twins: The role of hormone replacement therapy

Abstract

AbstractObjectiveTo examine the association between reproductive duration and postmenopausal depression (taking the use of hormone replacement therapy [HRT] into account).MethodsIn this population‐based cohort study, 11 320 postmenopausal women (mean age 63.6 years) were followed for up to 18 years. Reproductive duration was categorized into three groups: short (≤34 years), average (35–39 years), and long (≥40 years). Depression was ascertained from the Sweden National Patient Registry.ResultsDuring the follow up, 593 (5.24%) women developed depression. In the multi‐adjusted generalized estimating equation model, the odds ratios (ORs) of depression were 1.28 (95% confidence interval [CI] 1.05–1.55) and 1.25 (95% CI 1.01–1.55) for women with short and long reproductive durations, respectively, compared with those women with average reproductive duration. Women with a non‐typical reproductive duration (≤34 or ≥40 years) who received HRT were at a higher risk of depression (OR 1.82, 95% CI 1.42–2.33). There was a significant additive interaction between non‐typical reproductive duration and the use of HRT on depression (attributable proportion 0.26, 95% CI 0.03–0.50).ConclusionWomen with a short or long reproductive duration, especially those with a history of HRT use, have a higher risk of depression after menopause compared with those with an average reproductive duration.