The risk for major depression more than doubles while women are going through menopause and afterward, according to research presented this week at the annual meeting of the North American Menopause Society in San Diego.

Recent studies have suggested that the risk for depressive symptoms in women increases in midlife, around the time of menopause, perhaps because of the effects of reduced estrogen on the mind, and the stress of hot flashes and other symptoms. However, less is known about the risk for major depression.

To investigate, the University of Pittsburgh's Dr. Joyce T. Bromberger and colleagues analyzed follow-up data on 221 African American and White women enrolled in the ongoing prospective Study of Women's Health Across the Nation (SWAN).

When they entered the study, women were between 42 and 52 years old, premenopausal and taking neither hormone replacement therapy nor birth control pills.

Over 9 years, more than half of the women -- 129 - went through menopause, and about a third - 69 -- experienced at least one major depressive episode. Not surprisingly, those who had a history of major depression were more likely to have such an episode.

Women were more than twice as likely to have a major depressive episode as they were going through menopause, and almost four times as likely after menopause, compared to before menopause.

Based on this analysis, it looks like, indeed, there is a doubling of risk for major depression as women go through the menopausal transition, said study co-author Dr. Karen A. Matthews.

Matthews had this advice for doctors: When women come in and are thinking that they have some extra difficulties with life