This moderate to large effect size , showing lower ratings of depressed mood in treated patients compared with controls , implicated HRT as a potential treatment of or prophylactic for depression in menopausal women .
One can generalize from the studies review ed here only with great caution , but there is little evidence to support the use of estradiol to improve mood in nondepressed patients ( not surprisingly ) and some evidence to support the antidepressant efficacy of estradiol in perimenopausal but not postmenopausal women
BACKGROUND Controversy regarding the antidepressant efficacy of hormone replacement therapy ( HRT ) stems almost from its inception and reflects the same method ological inconsistencies that have compromised efforts to determine whether the perimenopause is accompanied by an increase in mood symptoms or depression .
Since this publication , multiple studies have aim ed to discern the relationship between HRT and menopausal mood .
METHODS The purpose of this systematic review is to examine the findings and quality of the evidence amassed since Zweifel and O'Brien 's meta- analysis .
Effect of estrogen replacement therapy on symptoms of depression and anxiety in non-depressive menopausal women
The efficacy of estrogen replacement therapy ( ERT ) for mood disturbances associated with menopause has yet to be firmly established . The objective of this study was to investigate the efficacy of ERT for improving mood and anxiety of non-depressive postmenopausal women . This double-blind , r and omized , placebo-controlled study involved two treatment groups : one receiving conjugated equine estrogens ( CEEs ; 0.625 mg/day ) and the other placebo , for six cycles of 28 days each . Subjects were hysterectomized , healthy , non-depressive ( according to Schedule for Affective Disorders and Schizophrenia , Life Time Version [ SADS-L ] ) women .  Depressive and anxiety symptoms were assessed with the Beck Depression Inventory ( BDI ) , and the Hamilton Anxiety Scale ( HAMA ) , respectively . The Profile of Mood States ( POMS ) and other scales were used to characterize symptoms . In both groups , BDI scores were significantly lower at cycles 1 , 2 , 3 , and 6 , compared with baseline assessment s ( p < 0.01 ) . Anxiety scores for both groups significantly improved from cycle 3 to study endpoint . The only significant difference favoring the active group occurred at cycle 1 . POMS scores were significantly improved at the end of cycles 1 , 2 , 3 and 6 among treated subjects and at the end of cycles 2 , 3 , and 6 among placebo subjects . ERT is not associated with improvements in mood or anxiety symptoms in non-depressive , hysterectomized , postmenopausal women
This moderate to large effect size , showing lower ratings of depressed mood in treated patients compared with controls , implicated HRT as a potential treatment of or prophylactic for depression in menopausal women .
One can generalize from the studies review ed here only with great caution , but there is little evidence to support the use of estradiol to improve mood in nondepressed patients ( not surprisingly ) and some evidence to support the antidepressant efficacy of estradiol in perimenopausal but not postmenopausal women
BACKGROUND Controversy regarding the antidepressant efficacy of hormone replacement therapy ( HRT ) stems almost from its inception and reflects the same method ological inconsistencies that have compromised efforts to determine whether the perimenopause is accompanied by an increase in mood symptoms or depression .
Since this publication , multiple studies have aim ed to discern the relationship between HRT and menopausal mood .
METHODS The purpose of this systematic review is to examine the findings and quality of the evidence amassed since Zweifel and O'Brien 's meta- analysis .