Premenstrual Mood Symptoms in the Perimenopause

Purpose of Review This review considers how reproductive aging may impact the trajectory of menstrually related mood disorders (MRMDs) such as premenstrual dysphoric disorder and considers how the treatment of MRMDs might require adjustment as patients approach midlife. Recent Findings The early menopause transition is accompanied by important hormonal changes that may exacerbate existing MRMDs. Indeed, recent research confirms that an important subset of women experiences depressive mood in response to perimenopausal elevations in ovarian hormones. In addition, a subset of women with an MRMD may exhibit an increased mood sensitivity to the ovarian hormone withdrawal that accompanies the late menopause transition and early postmenopausal phase. Though additional research is needed to clarify the trajectory of premenstrual dysphoria in the menopause transition, there is reason to believe that health care providers should be vigilant for a potential worsening of symptoms in perimenopause for women with past or current premenstrual dysphoric disorder.

Automated summary

Recent findings suggest that early menopause transition may exacerbate existing MRMDs due to hormonal changes, leading to depressive mood in some women. There is also evidence that some women with MRMD may have increased mood sensitivity to ovarian hormone withdrawal during late menopause transition and early postmenopausal phase. Further research is needed to clarify the trajectory of premenstrual dysphoria in the menopause transition and to be vigilant for potential worsening of symptoms in perimenopause for women with past or current premenstrual dysphoric disorder.