Tailoring strategies for the management of depression in midlife years.

Depression affects one in every five adults in North America. Women are more affected than men, possibly because of genetics, coping strategies, and hormone variations. The concept of a menopause-associated depression, however, remains a complex and controversial topic. Although hormone therapy is not recommended as first-line therapy for depression in midlife women, estrogen-based hormone therapy may minimize the need for or enhance the response to antidepressant or behavior-based therapies in select perimenopausal women.