Low mood and depressive symptoms during perimenopause – Should General Practitioners prescribe hormone replacement therapy or antidepressants as the first-line treatment?

Abstract

Perimenopausal women have an increased risk of developing new onset and recurrent mental health conditions such as anxiety, low mood and depressive symptoms. General Practitioners frequently prescribe antidepressants as the first-line treatment for these symptoms, despite clear lack of evidence for their efficacy and their unfavourable side effect profile. This article, written by a General Practitioner, gives a practical overview of the mental health symptoms which women may report to their General Practitioners during the menopausal transition and discusses underlying causes, assessment, risk factors and treatment options based on current evidence.