Section - Video Lectures

09. Take-Home Messages

Published on October 1, 2025 Certification expiration date: October 1, 2028

Katie Unverferth, M.D.

Assistant Clinical Professor of Psychiatry - U.C.L.A.

Key Points

SSRIs, SNRIs, and mirtazapine effectively treat perimenopausal depression while also improving sleep, anxiety, and vasomotor symptoms.
Estrogen with micronized progesterone improves vasomotor symptoms and may benefit mood in perimenopausal but not postmenopausal women.
Perimenopausal anxiety is linked to progesterone and allopregnanolone fluctuations due to anovulatory cycles and aging follicles.

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Slides and Transcript

Slide 1 of 16

Take-home Messages. So we’re going to review everything we’ve talked about.

Take-Home Messages Slide 1 of 16

Slide 2 of 16

First, definitions and diagnosis. Perimenopause is the transition phase leading up to menopause. It typically lasts for approximately four years, but can be longer or shorter depending on the person. It’s marked by hormonal fluctuations causing symptoms like vasomotor symptoms and irregular menstrual cycles. As a reminder, there is a lot of hormone fluctuation variability cycle to cycle. So diagnosis is clinical as the hormone levels vary, and levels might return to normal in certain cycles, and by normal I mean premenopausal levels.

Take-Home Messages Slide 2 of 16

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Learning Objectives:

After completing this activity, the learner will be able to:

Recognize the clinical manifestations of perimenopause, including vasomotor symptoms, mood changes, and cognitive complaints, and differentiate perimenopausal depression from other depressive disorders.
Identify risk factors for perimenopausal depression and anxiety, including prior history of hormone-sensitive mood disorders (PMDD, postpartum depression), vasomotor symptoms, psychosocial stressors, and psychological factors.
Select appropriate pharmacologic interventions for perimenopausal mood and vasomotor symptoms.

Original Release Date: October 1, 2025

Expiration Date: October 1, 2028

Expert: Katie Unverferth, M.D.

Medical Editor: Tomás Abudarham, M.D.

Relevant Financial Disclosures:

Katie Unverferth declares the following interests:

– Biogen/Sage: Consultant and Speakers Bureau
All the relevant financial relationships listed above have been mitigated by Medical Academy and the Psychopharmacology Institute.

None of the other faculty, planners, and reviewers for this educational activity has relevant financial relationships to disclose during the last 24 months with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

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Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medical Academy LLC and the Psychopharmacology Institute. Medical Academy is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation Statement

Medical Academy designates this enduring activity for a maximum of 0.75 AMA PRA Category 1 credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Artificial Intelligence (AI) Use DisclosureArtificial intelligence (AI) tools may have been used in limited stages of developing this activity (e.g., drafting or language refinement). The specific tool, version, and date of use are documented internally.AI does not determine clinical recommendations. All content is reviewed, verified, and approved by the listed faculty and medical editors, and reflects independent human clinical judgment consistent with ACCME Standards for Integrity and Independence in Accredited Continuing Education.

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