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 .
The effect of 3-year treatment with 0.25 mg/day of micronized 17beta-estradiol on cognitive function in older postmenopausal women.
OBJECTIVES To evaluate the effect of ultra-low-dose ( 0.25 mg/d ) micronized 17beta-estradiol on cognitive function in older postmenopausal women . DESIGN R and omized , placebo-controlled trial conducted for 3 years . SETTING Academic health center in greater Hartford , Connecticut . PARTICIPANTS Fifty-seven healthy , community-dwelling , older postmenopausal women . INTERVENTION Women received 0.25 mg/d of micronized 17beta-estradiol ( estrogen therapy ( ET ) , n=32 ) or placebo ( n=25 ) ; all women who had not had a hysterectomy received 100 mg/d of oral micronized progesterone for 2-week periods every 6 months . MEASUREMENTS Neuropsychological measures of memory , language , mood , and executive function were collected at baseline , 3 months , and 36 months . Measures of executive function included the Controlled Oral Word Association Test , the Trail Making Test , and the Wisconsin Card Sorting Test . The Boston Naming Test was used to measure language skills . The Symbol Digit Modalities Test was used as a measure of sustained attention . Measures of memory included the Complex Figure Test , Fuld Object Memory Test , and a selected subtest from the Wechsler Memory Scale . Scores from the Geriatric Depression Scale and the Beck Anxiety Inventory were used to assess symptoms of depression . RESULTS No differences were found between ET and placebo on any of the neurocognitive measures or depression instruments , nor were there any differences when the groups were stratified according to age . CONCLUSION This small study , which had adequate power to detect change in some but not all domains of cognition tested , revealed that low-dose estrogen neither benefits nor harms cognitive function in older women after 3 years of treatment , but confirmation is needed from larger trials
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 .