Dear Dr. Pat,

I’m 49 years old and beginning to go through menopause. I haven’t had a period for nine months now. I don’t have any hot flashes to speak of but my mood has really taken a turn for the worse. I was generally an optimistic person, but lately everything has felt overwhelming. Some days, I don’t want to get out of bed. At work, I am having trouble concentrating, but that may be in part because I am so tired. I wake up at about 4 a.m. every morning and can’t fall back to sleep because I begin to think about my life being over half gone and what to do next. This has all been going on for about six months. My kids are off to college at this point and my husband and I had made plans about how we would be spending this time, but  I’m not looking forward to anything. Before this, I was doing really well, both physically and mentally. I did experience similar symptoms after the birth of both of my children, but each time it resolved after a month or so and I did not seek treatment. Now, though, I think I may need to do something more to deal with all this. Is this common for women of my age? Any suggestions?

Thanks,
Cynthia

Dear Cynthia,

Some women do report a change in mood during major life transitions such as the birth of a child or a change in the structure of family life once children have left the home. Hormonal change may be a trigger for the depressed mood you describe, both after the birth of children and now during the perimenopausal transition. You are right to ask open-ended questions and not assume that your symptoms are due just to hormonal change.

We have asked Dr. Megan Riddle to respond to your concerns and offer diagnostic steps and therapeutic options that you may want to discuss with your health care team. You have already made a valuable first step: you have asked for information and help. We are here for you.

Dr. Pat