Skip Navigation LinksHome > November 2013 - Volume 20 - Issue 11 > Lifetime endogenous reproductive factors and severe depressi...
Menopause:
doi: 10.1097/GME.0000000000000098
Original Study

Lifetime endogenous reproductive factors and severe depressive symptoms in postmenopausal women: findings from the E3N cohort

Perquier, Florence MSc1,2,3; Ryan, Joanne PhD4,5; Ancelin, Marie-Laure PhD4; Mesrine, Sylvie MD1,2,3; Clavel-Chapelon, Françoise PhD1,2,3

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Abstract

Objective

This study aims to identify reproductive factors associated with severe depressive symptoms (SDS) in postmenopausal women and to determine whether a past psychological disorder (PPD) and the timing of first-onset PPD in relation to menopause modify associations.

Methods

Lifetime reproductive characteristics and PPD were obtained from 51,088 postmenopausal women of the E3N cohort study. The Center for Epidemiologic Studies—Depression Scale (CES-D) was used to assess SDS. Multivariate logistic regression models were performed to estimate the risk of SDS overall and according to the presence and timing of first-onset PPD (before the final menstrual period, in early postmenopause, or in late postmenopause).

Results

Women with irregular cycles were at increased risk for SDS (odds ratio [OR], 1.35; 95% CI, 1.19-1.53), except when PPD occurred in early postmenopause (OR, 1.08; 95% CI, 0.74-1.57). Parity was inversely associated with the risk of SDS (P < 0.001), whereas decreasing age at first full-term pregnancy increased the risk of SDS with PPD (P < 0.001) and increasing age at last full-term pregnancy increased the risk of SDS without PPD (P = 0.012). Age at final menstrual period (per 2-y increment) was associated with a decreased risk of SDS with postmenopausal (especially late postmenopausal) PPD (OR, 0.82; 95% CI, 0.80-0.85) but with an increased risk of SDS when PPD occurred before the final menstrual period (OR, 1.15; 95% CI, 1.12-1.19). Artificial menopause increased the risk of SDS with PPD before the final menstrual period (OR, 1.40; 95% CI, 1.18-1.66), whereas menopausal symptoms were associated with SDS across all categories.

Conclusions

Associations between endogenous reproductive factors and SDS may vary according to the presence of PPD and the timing of first-onset PPD. Further studies are warranted.

© 2013 by The North American Menopause Society

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