Women who experience multiple traumatic events during childhood or adolescence may be at an increased risk of depression in the years leading into menopause -- known as perimenopause, a study has showed.

The findings revealed that women who reported two or more adverse childhood experiences -- such as emotional abuse, parental separation or divorce -- after the onset of puberty were 2.3 times more likely to have their first experience of major depressive disorder during perimenopause.

The hormonal changes that occur during menopause may unmask previously undetected risk for depression in women who experienced adverse childhood experiences, particularly when the events occurred after puberty, the researchers said.

"Our results show that women who experience at least two adverse events during their formative years -- whether it be abuse, neglect, or some type of family dysfunction -- are more than twice as likely to experience depression during perimenopause and menopause as women who either experienced those stressors earlier in life, or not at all," said lead author C. Neill Epperson, Professor at the University of Pennsylvania.

"This suggests that not only does early life stress have significant and long-lasting effects on the development and function of the regions of the brain responsible for emotions, mood, and memory the timing of when the event occurs may be equally as important," Epperson added, in the paper published in the Journal of Clinical Psychiatry.

Dramatic changes in hormone levels are experienced during both puberty and menopause. "There's clearly a strong link between childhood adversity and risk of depression, throughout a woman's life but particularly during the transition to menopause," said Ellen W. Freeman, Professor at the University of Pennsylvania. Although depression is common during a woman's transition to menopause, understanding who is at-risk of experiencing depression during this period of hormonal fluctuation may pave way for better treatments.