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Association of past and recent major depression and menstrual characteristics in midlife: Study of Women’s Health Across the Nation

Bromberger, Joyce T. PhD1; Schott, Laura L. PhD2; Matthews, Karen A. PhD3; Kravitz, Howard M. DO, MPH4; Randolph, John F. Jr MD5; Harlow, Sioban PhD6; Crawford, Sybil PhD7; Green, Robin PhD8; Joffe, Hadine MD, MSc9

doi: 10.1097/gme.0b013e318248f2d5
Original Articles

Objective The aim of this study was to examine the association of a history of major depression (MD) with menstrual problems in a multiethnic sample of midlife women.

Methods Participants were 934 women enrolled in the Study of Women’s Health Across the Nation, a multisite study of menopause and aging. The outcomes were menstrual bleeding problems and premenstrual symptoms in the year before study entry. The Structured Clinical Interview for the Diagnosis of DSM-IV Axis I Disorders was conducted to determine recent and past psychiatric diagnoses. Covariates included sociodemographic, behavioral, and gynecologic factors.

Results One third of the participants reported heavy bleeding, 20% reported other abnormal bleeding, and 18% reported premenstrual symptoms. One third had past and 11% had recent MD. Past MD was associated with an increased likelihood of heavy bleeding (odds ratio, 1.89; 95% CI, 1.25-2.85), adjusting for recent MD, menopause status, and other covariates. Past MD was not associated with other abnormal bleeding or premenstrual symptoms in the final analysis that adjusted for recent MD.

Conclusions Midlife women with a history of MD are more likely to report heavy bleeding.

From the 1Department of Epidemiology, Graduate School of Public Health and Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA; 2Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA; 3Departments of Psychiatry, Epidemiology, and Psychology, University of Pittsburgh, Pittsburgh, PA; 4Departments of Psychiatry and Preventive Medicine, Rush University Medical Center, Chicago, IL; 5Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI; 6Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI; 7Department of Epidemiology and Biostatistics, University of Massachusetts Medical Center, Worcester, MA; 8Department of Obstetrics/Gynecology & Women’s Health, Albert Einstein College of Medicine, JerseyCity, NJ;and 9Center for Women’s Mental Health, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston,MA.

Received November 4, 2011; revised and accepted December 29, 2011.

Funding/support: This work was supported by National Institutes of Health (NIH) Grants NR004061, AG012505, AG012535, AG012531, AG012539, AG012546, AG012553, AG012554, AG012495, and AG029216. Supplementalfunding was provided by National Institute of Mental Health Grants MH59689, MH59770, and MH59688.

Financial disclosure/conflicts of interest: Dr. Joffe has had research supportfrom Cephalon and provided advisory/consulting services to Sunovion and Noven.

The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Aging, the National Institute of Nursing Research, the Office of Research on Women’s Health, or the NIH.

Address correspondence to: Joyce T. Bromberger, PhD, 3811 O’Hara Street, Pittsburgh, PA 15213. E-mail:

©2012The North American Menopause Society