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 .
Lack of efficacy of estradiol for depression in postmenopausal women: a randomized, controlled trial
BACKGROUND Estrogen has been considered as a potential antidepressant in postmenopausal women . Our goal was to study whether estrogen therapy is effective in treating depressive disorders in older postmenopausal women and to determine whether progestins are associated with a deterioration of mood . METHODS After 2 weeks of single-blind placebo treatment in 87 patients , 57 were r and omly assigned to receive 8 weeks of treatment with estradiol ( .1 mg/day ; n = 31 ) or placebo ( n = 26 ) . All patients were then treated with medroxyprogesterone 10 mg/day for 2 weeks combined with the study patch .  Depressive symptoms were rated with the 21-item Hamilton Depression and Center for Epidemiologic Studies Depression scales . RESULTS A clinical ly significant antidepressant effect of estradiol was excluded after 8 weeks of estradiol treatment . The estradiol group and placebo group improved in depressive symptoms at a similar rate based on the Hamilton Depression Scale ( 40 % decreases in depression for estradiol vs. 44 % for placebo ) . No significant increase in depressive symptoms was demonstrated with the use of progestins ; however , positive affect decreased slightly with the use of combined estradiol-medroxyprogesterone compared with medroxyprogesterone alone ( 5.8 % , p = .027 ) . CONCLUSIONS Estradiol can not be considered as an effective treatment in postmenopausal women with mild to moderate depression
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 .