The Role and Mechanism of Estrogen in Perimenopausal Depression

Depression is a severe psychiatric disorder characterized by high prevalence rates, elevatedsuicide risks, and significant relapse rates. Women, particularly during the perimenopausal period,are more vulnerable to developing depression. Fluctuations in estrogen levels during perimenopausecan heighten a woman's sensitivity to psychosocial stress. Clinical trials have demonstrated theshort-term antidepressant efficacy of estradiol in perimenopausal women. However, the precisemechanisms through which estrogen influences mood disorders during perimenopause remainunclear. This review summarizes the risk factors associated with perimenopausal depression (PMD),examines current research on estrogen therapy, and explores the potential mechanisms and relatedpathological processes involved in estrogen's role in treating depression. Understanding how estrogenmitigates depressive symptoms in perimenopausal women may help reduce the morbidity andmortality associated with PMD while also alleviating its socioeconomic burden.