By Linda Carroll

(Reuters Health) – Even though studies have shown that some 40% of women experience depression as they go through menopause, more than a third of gynecologists don’t screen for it, a survey finds.

While most of the gynecologists surveyed said they believed they could recognize depression in perimenopausal women, almost half did not feel confident in their ability to treat depressed patients, according to the report published in Menopause.

The new findings suggest gynecologists need more training in diagnosing and treating depression, said the study’s lead author, Greta Raglan, an assistant professor in the psychiatry department at the University of Michigan. “And for the consumer, it’s important to understand that the risk for depression is higher during the perimenopausal period,” Raglan said.

Because doctors may not be screening for depression, it’s important for a woman to know the symptoms, which can be different during menopause, Raglan said.

“There’s less sadness and more irritability and more frequent mood changes,” Raglan said.

Among the signs women should look out for are: lower than usual mood, less interest in activities that typically give one pleasure, difficulty falling asleep and staying asleep, having feelings of guilt or worthlessness, changes in energy level and thoughts of suicide or death.

To see how many gynecologists were screening for depression in their menopausal patients, Raglan and her team reached out to members of the Collaborative Ambulatory Research Network (CARN), a group of gynecologists who have volunteered to participate in surveys on a regular basis without compensation.

Invitations to take the depression survey were sent to 500 CARN members who were also members of the American College of Obstetricians and Gynecologists, and 206 opted to participate. The researchers pruned that number down to 197 after excluding physicians who only treated pregnant women, were retired or did not complete the survey.

The majority of the doctors surveyed, 65.9%, said they screened menopausal patients for depression, but 34.1% said they typically did not. Female doctors were more likely than males to say they screened, 72.4% versus 55.4%. Those who had experienced depression themselves or knew someone who had, were also more likely to say they screened for the condition: 70.8% versus 50.0%. Doctors who had been trained in treating depression were also more likely to screen for it, 80.7% versus 59.2%.

Just over half, 55.8%, of the doctors said they felt confident in their ability to treat depression in menopausal women.

The new findings didn’t come as a surprise to Dr. Katherine Scruggs, an assistant professor of obstetrics and gynecology at Magee-Womens Hospital in Pittsburgh who wasn’t involved in the study. “Training in menopausal issues is generally lacking in residencies,” Scruggs said.

With the shortage of mental health providers it would make sense for gynecologists to get more training in diagnosing and treating depression in menopausal women, she added.

Gynecologists are often the first, or even the only, doctor women go to see, said Dr. Elissa Gretz Friedman, director of the Menopause Center at Mount Sinai in New York City, who also wasn’t involved in the study.

“Additionally, the perimenopause can be a time of irregular bleeding and other symptoms, such as hot flashes, that will bring a woman in to see her (gynecologist),” Gretz Friedman said in an email. “This gives us the opportunity to identify a depressed patient. One third of (gynecologists) are not screening and this is a wakeup call.”

SOURCE: Menopause, online January 13, 2020.