Affective syndrome during perimenopause.

Perimenopause is characterized by decreasing levels of estrogens and progesterone until gonadal secretion comes to a complete halt. There are still very different views and positions on the significance of the menopause. Physical, mental-vegetative and depressive symptoms during climacteric are different in each culture. Currently, there is some controversy as to whether or not there really is a rise in actual depression during the perimenopausal phase of woman's life. The observations from humans taken together indicate that depressive disorders, as defined in ICD-10, do not occur more frequently during perimenopause. In this context, the terms subthreshold depression and or subsyndromal depression are important, describing depressive symptoms which do not fulfil the complete clinical picture of a depressive episode, either because there are not enough symptoms or because they are not severe enough. The affected women still suffer, but until now not enough studies have been carried out on this particular area. In view of the complexity and relevance of the perimenopausal period in a woman's life, it is necessary to establish and maintain a network of treatment between the family physician, gynecologist, psychiatrist and or psychotherapist, as soon as significant depressive symptoms occur.