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Objectives Evaluation and management of anxiety and depression during the menopausal transition are complicated by the overlap between some symptoms of affective disorder with those of menopausal symptoms, and also by inconsistencies in the literature regarding the relationship between the menopausal transition and affective disorders.

Methods We have reviewed key studies over the past three decades addressing depression and anxiety during the menopause transition, in order to present a practical, clinical approach to the evaluation and management of anxiety and depressive symptoms at midlife.

Results Symptoms of anxiety and depression are common at midlife and may coincide with menopausal symptoms. Some menopausal symptoms are also symptoms of anxiety and/or depression. Management should include treatment of troublesome menopausal symptoms, providing strategies to deal with …