Depressive Disorders Related to Female Reproductive Transitions

Abstract

Depression is rapidly becoming a major health concern. Recent estimates rank it as the fourth leading cause of disease burden worldwide, and its incidence is steadily increasing. Women have a risk of experiencing depressive illnesses that is twice that of men. Women with depression also typically experience greater functional impairment. The incidence of depression dramatically increases during the reproductive years, which correspond to ages 25 to 44 years. During this time frame, women may experience several reproductive milestones or transitional events such as menarche, the menstrual cycle, pregnancy, infertility, miscarriage, and perimenopause/menopause. These transitions evoke neuroendocrinologic changes that appear to influence the risk for depressive episodes. Common disorders associated with these hormonal fluctuations include premenstrual dysphoric disorder, postpartum depression, and depression in the perimenopausal transition. Although the specific pathophysiologic association is still unclear, evidence supports that these reproductive transitions influence the risk of depression in women.