Epidemiology of Depression Throughout the Female Life Cycle

Women are at an increased risk for first onset of major depression from early adolescence untiltheir mid-50s and have a lifetime rate of major depression 1.7 to 2.7 times greater than that for men.There is accumulating evidence that certain reproductive-related hormonal changes place womenat increased risk for depression. For example, puberty marks the beginning of increased risk for depressionin women. Most women report physical or emotional symptoms premenstrually, with somesevere enough to be diagnosed as premenstrual dysphoric disorder. While pregnancy does not increasethe risk for depression, women with past histories of depression are at risk for recurrent episodesor relapse if antidepressant medications are discontinued. Hormonal changes during the postpartumperiod also increase the incidence of depression. Similarly, women transitioning through perimenopause,particularly those with past psychiatric histories, report depressive symptoms. Prophylaxis andtreatment to minimize severity in cases of recurrence are discussed in the article, using reproductivetransitional events as markers.