The effect of depression on reproductive health among women of reproductive age

Fatma Kardaş, Filiz Okumuş


While the majority of research on depression, which is classified as a mental health disorder, tends to focus on pregnancy, few studies have investigated the relationship and possible effects of depression on reproductive health. This study was conducted with the aim of determining the relationship between depression and reproductive health outcomes in non-pregnant women of reproductive age.  This was a case control study that consisted of 301 women who attended gynecology outpatient clinic of a university training and research hospital of South of Turkey between May and November of 2015. This study used the Beck Depression Inventory to evaluate depression level. Data was analyzed using IBM SPSS for Windows, version 21.0. According to the outcomes of this study, 33.9% of the women evaluated were found to have depression. In addition, the findings demonstrated that there is a difference between women with and without depression in terms of reproductive health outcomes. Taking into account the current and past records of psychiatric disorders documented during the treatment of women who were attended to in to gynecological clinics, this study further showed that better gynecological wellness can be achieved using short screening scales that can refer women for early diagnosis and treatment. (Afr J Reprod Health 2021; 25[5]: 125-132).

Full Text:



van Dammen L, Wekker V, de Rooij SR, Groen H, Hoek

A and Roseboom TJ. A systematic review and meta-analysis of lifestyle interventions in women of reproductive age with overweight or obesity: the effects on symptoms of depression and anxiety. Obes Rev. 2018;19(12):1679-1687. doi:10.1111/obr.12752

World Health Organization. Depression: Fact Sheet.;

Soyannwo T, Adebayo AM and Sigbeku O. Mental health

problems of reproductive age group women in a rural community of south west Nigeria. J Ment Heal. 2018;00(00):0-1. doi:10.1080/09638237.2018.1487533

Ahluwalia IB, Mack KA and Mokdad A. Mental and

physical distress and high-risk behaviors among reproductive-age women. Obstet Gynecol. 2004;104(3):477-483. doi:10.1097/01.AOG.0000137920.58741.26

Ko JY, Farr SL, Dietz PM and Robbins CL. Nonpregnant

Women of Reproductive Age , 2005 – 2009. J Women’S Heal. 2012;21(8):830-836. doi:10.1089/jwh.2011.3466.Depression

Bayrampour H, McDonald S and Tough S. Risk factors of

transient and persistent anxiety during pregnancy. Midwifery. 2015;31(6):582-589. doi:10.1016/j.midw.2015.02.009

Melville JL, Gavin A, Guo Y, Fan M and Katon WJ.

Depression disorders during pregnancy. Obstet Gynecol. 2010;116(5):1064-1070.

Yilmaz FA, Avci D, Aba YA, Ozdilek R and Dutucu N.

Sexual dysfunction in postpartum Turkish women: It’s relationship with depression and some risk factors. Afr J Reprod Health. 2018;22(4):54-63. doi:10.29063/ajrh2018/v22i4.6

Grote NK, Bridge JA, Gavin AR, Melville JL, Iyengar S

and Katon WJ. A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Arch Gen Psychiatry. 2010;67(10):1012-1024. doi:10.1001/archgenpsychiatry.2010.111

Freeman EW and Sammel MD. Methods in a longitudinal

cohort study of late reproductive age women: the Penn Ovarian Aging Study (POAS). Women’s Midlife Heal. 2016;2(1):1-11. doi:10.1186/s40695-016-0014-2

Farr SL, Bitsko RH, Hayes DK and Dietz PM. Mental

health and access to services among US women of reproductive age. Am J Obstet Gynecol. 2010;203(6):542.e1-542.e9. doi:10.1016/j.ajog.2010.07.007

Kendig S, Keats JP, Hoffman MC, Kay LB, Miller ES,

Simas TAM, Frieder A, Hackley B, Indman P, Raines C, Semenuk K, Wisner KL and Lemieux LA. Consensus Bundle on Maternal Mental Health: Perinatal Depression and Anxiety. JOGNN - J Obstet Gynecol Neonatal Nurs. 2017;46(2):272-281. doi:10.1016/j.jogn.2017.01.001

Soares CN. Mood disorders in midlife women:

Understanding the critical window and its clinical implications. Menopause. 2014;21(2):198-206. doi:10.1097/GME.0000000000000193

Georgakis MK, Thomopoulos TP, Diamantaras AA,

Kalogirou EI, Skalkidou A, Daskalopoulou SS and Petridou ET. Association of age at menopause and duration of reproductive period with depression after menopause: A systematic review and meta-analysis. JAMA Psychiatry. 2016;73(2):139-149. doi:10.1001/jamapsychiatry.2015.2653

Sassarini DJ. Depression in midlife women. Maturitas.

Published online 2016:149-154. doi:10.1016/j.maturitas.2016.09.004

Stoffel EC and Craft RM. Ovarian hormone withdrawal-

induced “depression” in female rats. Physiol Behav. 2004;83(3):505-513. doi:10.1016/j.physbeh.2004.08.033

Joffe H, Chang Y, Dhaliwal S, Hess R, Thurston R, Gold

E, Matthews KA and Bromberger JT. Lifetime history of depression and anxiety disorders as a predictor of quality of life in midlife women in the absence of current illness episodes. Arch Gen Psychiatry. 2012;69(5):484-492. doi:10.1001/archgenpsychiatry.2011.1578

Le Strat Y, Dubertret C and Le Foll B. Prevalence and

correlates of major depressive episode in pregnant and postpartum women in the United States. J Affect Disord. 2011;135(1-3):128-138. doi:10.1016/j.jad.2011.07.00

Prasad JH, Abraham S, Kurz KM, George V, Lalitha MK,

John R, Jayapaul MN, Shetty N and Joseph A. Reproductive tract infections among young married women in Tamil Nadu, India. Int Fam Plan Perspect. 2005;31(2):73-82. doi:10.1363/3107305

Patel V, Kirkwood BR, Pednekar S, Pereira B, Barros P,

Fernandes J, Datta J, Pai R, Weiss H and Mabey D. Gender disadvantage and reproductive health risk factors for common mental disorders in women: A community survey in India. Arch Gen Psychiatry. 2006;63(4):404-413. doi:10.1001/archpsyc.63.4.404

Mendonsa RD and Appaya P. Psychiatric morbidity in

outpatients of gynecological oncology clinic in a tertiary care hospital. Indian J Psychiatry. 2010;52(4):327-332. doi:10.4103/0019-5545.74307

Survey Sampling. By Leslie Kish. (New York: John

Wiley & Sons, Inc., 1965. Pp. xvi, 643. $10.95.). Am Polit Sci Rev. Published online 1965. doi:10.1017/s0003055400132113

Ozyurt BC and Deveci A. The relationship between

domestic violence and the prevalence of depressive symptoms in married women between 15 and 49 years of age in a rural area of Manisa, Turkey. Turk Psikiyatr Derg. 2011;22(1):10-16.

Ceylan A, Özen Ş, Palanci Y, Saka G, Aydın YE, Kıvrak

Y and Tangolar Ö. Anxiety-depression levels and harmful habits at last year of high school students: The research of Mardin province.[Turkish: Lise son sinif öğrencilerinde anksiyete-depresyon düzeyleri ve zararli alişkanlıklar: Mardin çalişmasi]. Anadolu Psikiyatr Derg. 2003;23(4):1481-1494.

Guo N, Robakis T, Miller C and Butwick A. Prevalence

of depression among women of reproductive age in the United States. Obstet Gynecol. 2018 Apr;131(4):671-679. doi: 10.1097/AOG.0000000000002535. PMID: 29528926; PMCID: PMC5991477.

Zhou J, Ko JY, Haight SC and Tong VT. Treatment of

substance use disorders among women of reproductive age by depression and anxiety disorder status, 2008-2014. J Womens Health (Larchmt). 2019 Aug;28(8):1068-1076. doi: 10.1089/jwh.2018.7597. Epub 2019 Jul 12. PMID: 31298606.

Lin SC, Tyus N, Maloney M, Ohri B and Sripipatana A.

Mental health status among women of reproductive age from underserved communities in the United States and the associations between depression and physical health. A cross-sectional study. PLoS One. 2020 Apr 8;15(4):e0231243. doi: 10.1371/journal.pone.0231243. PMID: 32267903; PMCID: PMC7141664.

Demirel O.F, Mayda P.Y, Yıldız N, Sağlam H, Koçak

B.T, Habip Z, Kadak M.T, Balcıoğlu İ and Kocazeybek B. The effect of stigma on depression levels of Turkish women with infertility Eur.J.Psychiat. 2018;32(4):182-186.

Yilmaz E and Kavak F. The effect of stigma on depression

levels of Turkish women with infertility. Perspect Psychiatr Care. 2019 Jul;55(3):378-382. doi: 10.1111/ppc.12319. Epub 2018 Jul 27. PMID: 30052266.

İkican T.C, Coşansu G, Erdoğan G, Küçük L and Bilim

Özel İ. The Relationship of Marital Adjustment and Sexual Satisfaction with Depressive Symptoms in Women. Sex Disabil. 2020; 38:247–260

Omani Samani R , Maroufizadeh S, Almasi Hashiani A

and Amini P. Prevalence of depression and its determinant factors among infertilepatients in Iran based on the PHQ-9. Middle East Fertil. Soc. J. 2018; 23: 460–463.

Indu PS, Anilkumar TV, Vijayakumar K, Kumar KA,

Sarma PS, Remadevi S and Andrade C. Reliability and validity of PHQ-9 when administered by health workers for depression screening among women in primary care. Asian J Psychiatr. 2018 Oct;37:10-14. doi: 10.1016/j.ajp.2018.07.021. Epub 2018 Jul 30. PMID: 30096447.

Goodwin RD, Cheslack-Postava K, Nelson DB, Smith

PH, Wall MM, Hasin DS, Nomura Y, Galea S. Smoking during pregnancy in the United States, 2005-2014: The role of depression. Drug Alcohol Depend. 2017 Oct 1;179:159-166. doi: 10.1016/j.drugalcdep.2017.06.021. Epub 2017 Jul 18. PMID: 28783546; PMCID: PMC5635833.

Obisesan OH, Mirbolouk M, Osei AD, Orimoloye OA,

Uddin SMI, Dzaye O, El Shahawy O, Al Rifai M, Bhatnagar A, Stokes A, Benjamin EJ, DeFilippis AP and Blaha MJ. Association between e-cigarette use and depression in the behavioral risk factor surveillance system, 2016-2017. JAMA Netw Open. 2019 Dec 2;2(12):e1916800. doi: 10.1001/jamanetworkopen.2019.16800. PMID: 31800073; PMCID: PMC6902792.

Coll CVN, da Silveira MF, Bassani DG, Netsi E,

Wehrmeister FC, Barros FC, Stein A. Antenatal depressive symptoms among pregnant women: Evidence from a Southern Brazilian population-based cohort study. J Affect Disord. 2017 Feb;209:140-146. doi: 10.1016/j.jad.2016.11.031. Epub 2016 Nov 26. PMID: 27914247; PMCID: PMC5282400.

Okumuş F and Demirci N. Health-seeking behavior in the

case of vaginal discharge in women living in rural areas. Journal of Anatolia Nursing and Health Sciences. 2015;18 (3):204-2 [Turkish]

Uwakwe KA, Iwu AC, Obionu CN, Duru CB, Obiajuru

IC and Madubueze UC. Prevalence, pattern and predictors of abnormal vaginal discharge among women attending health care ınstitutions in Imo State, Nigeria. Journal of Community Medicine and Primary Health Care.2018; 30 (2) 22-35

Chaudhary V, Kumar R, Agrawal K.V, Singh A, Narula

R and Sharma M. Prevalence and determinants of vaginal discharge among women of reproductive age group in tertiary care hospital of northern India. Natl J Community Med.2012;3(4):661-665

Ranjit E, Raghubanshi BR, Maskey S and Parajuli P.

Prevalence of bacterial vaginosis and its association with risk factors among nonpregnant women: A hospital based study. Int J Microbiol. 2018 Mar 5;2018:8349601. doi: 10.1155/2018/8349601. PMID: 29692813; PMCID: PMC5859802.

Jacob L, Gerhard C, Kostev K and Kalder M. Association

between induced abortion, spontaneous abortion, and infertility respectively and the risk of psychiatric disorders in 57,770 women followed in gynecological practices in Germany. J Affect Disord. 2019 May 15;251:107-113. doi: 10.1016/j.jad.2019.03.060. Epub 2019 Mar 20. PMID: 30921593.

Drewes M, Kalder M and Kostev K. Factors associated

with the diagnosis of depression in women followed in gynecological practices in Germany. J Psychiatr Res. 2021 Jul 14;141:358-363. doi: 10.1016/j.jpsychires.2021.07.018. Epub ahead of print. PMID: 34304041.


  • There are currently no refbacks.