Hormonal therapies for new onset and relapsed depression during perimenopause

In recent years the perimenopause has become recognised as a ‘window of vulnerability’ for women's mood. The risk of depression during perimenopause is high and treatment failure is common. Perimenopausal depression encompasses both new onset (first episode) depression occurring during perimenopause as well as a relapse during perimenopause in women with a history of depression. Perimenopausal depression is increasingly recognised as a new subtype of depression with specific clinical characteristics. Current treatments for perimenopausal depression have high failure rates, multiple adverse effects and potentially damaging long term consequences. This review examines both new onset and relapsed depression during perimenopause, biological mechanisms of perimenopausal depression, and the role of hormonal therapies.