Menarche age, menopause age and other reproductive factors in association with post-menopausal onset depression: Results from Health Examinees Study (HEXA)

Although there are plausible mechanisms of female hormones in depression, epidemiological evidence has shown conflicting results.This study aimed to evaluate the associations between female hormonal events and post-menopausal depression and further investigate the relative association between the age of menarche, the age of menopause and depression.Among 111,589 women who took part in the Health Examinees (HEXA) Study, a total of 60,114 postmenopausal participants were included in the final analysis. Each participant provided information on depression and questions related to reproductive history. The outcome variable was self-reported by the history of depression diagnosed by physicians and the Center for Epidemiologic Studies Depression Scale (CES-D) score. With the multivariate logistic regression, odds ratios were calculated. Possible interactions between depression prevalence and the ages of menarche and menopause were assessed.A total of 2.2% (1342/60,114) women were diagnosed with depression after menopause, and 5.9% (500/8472) showed depressive symptoms. As the age of menopause and duration of reproductive years increased, the odds ratio of depression decreased (P-trend <0.001). As the age of menarche increased, the likelihood of physician-diagnosed depression also increased (P-trend 0.048). As the number of both spontaneous and induced abortions increased, the odds ratio of depression increased (P-trend <0.001).it is possible that women show inaccuracies in recalling their hormonal events and reporting other past mental disorders as depression.Both the ages of the initiation and the termination of menstruation were associated with the increased odds ratio of post-menopausal depression. However, the age of menopause seems to be more important.