The perimenopause is commonly defined as a time of hormonal fluctuation that typically occurs in women 40-55 years of age with changes in menstrual patterns (Soares et al. 2001; Cohen et al. 2003). Women are at a particularly high risk for depressive symptoms during the perimenopause, as demonstrated by epidemiological data that support a higher risk in perimenopause (15-18% prevalence rates) than premenopause (8-12%) (Bromberger et al., 2003). Women may be especially vulnerable to depressive symptoms during perimenopause due to declining levels of estrogen. Estrogen interacts with the neurotransmitter serotonin and its receptor expression, and may have antidepressant effects; estrogen monotherapy may alleviate depressive symptoms and has been associated with improved quality of life (Soares et al. 2001; Cohen et al., 2003). Of great practical clinical importance, hormone replacement therapy has become increasingly controversial in light of the findings of the Women's Health Initiative study (Roussouw et al.,2002). Soares et al. (2003) found that women with perimenopausal and postmenopausal depression responded well with treatment with citalopram alone and in combination with estrogen. Venlafaxine, mirtazapine, escitalopram, and duloxetine appear efficacious in open pilot studies for perimenopausal depression (Ladd et al., 2005, Joffe et al. 2001; Freeman et al., 2006; Joffe et al., 2007). However, antidepressant medications may be associated with significant side effects. Clinicians, researchers, and patients are now seeking alternative treatments for menopausal-related emotional and physical symptoms.