Abstract: Perimenopause period is a high risk period of new and recurrent depression. Perimenopausal depressive disorder (PDD) is a common disorder related to the physical and mental health, as well as life quality, of middle aged women. The initial factor of PDD is the degradation of ovarian function, which lead to the decreased estrogen and the weaken negative feedback to hypothalamus and pituitary. The fluctuating hormonal level during the menopausal transition may increase vulnerability to depression. Perimenopausal depression may not only accelerate the primary course of depression, but also increase the risk of physical disorders including cardiovascular disease, diabetes and osteoporosis. Studies on the treatment of perimenopausal disorder showed that the main treatment was antidepressant, and antidepressant combined with hormone replacement for those refractory PDD patients. Because long term of estrogen therapy could increase the risk of breast canscer and endometrial carcinoma, it is usual that progesterone was combined with estrogen in clinical practice. This review introduced the combined therapy with estrogen and antidepressant for PDD.

Key words: Perimenopause, Depressive disorder, Depressive dsorder, major, Estrogen replacement therapy, Antidepressive agents