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 .
Menopause and the risk of coronary heart disease in women.
To determine the relation of menopause to the risk of coronary heart disease , we analyzed data on a prospect i ve cohort of 121,700 U.S. women 30 to 55 years old who were followed from 1976 to 1982 . Information on menopausal status , the type of menopause , and other risk factors was obtained in 1976 and up date d every two years by mailing question naires . Through 1982 , the follow-up rate was 98.3 percent for mortality and 95.4 percent for nonfatal events . After we controlled for age and cigarette smoking , women who had had a natural menopause and who had never taken replacement estrogen had no appreciable increase in the risk of coronary heart disease , as compared with premenopausal women ( adjusted rate ratio , 1.2 ; 95 percent confidence limits , 0.8 and 1.8 ) . Again compared with premenopausal women , the occurrence of a natural menopause together with the use of estrogens did not affect the risk ( rate ratio , 0.8 , 95 percent confidence limits , 0.4 and 1.3 ) . Women who had undergone bilateral oophorectomy and who had never taken estrogens after menopause had an increased risk ( rate ratio , 2.2 ; 95 percent confidence limits , 1.2 and 4.2 ) . However , the use of estrogens in the postmenopausal period appeared to eliminate this increased risk among these women as compared with premenopausal women ( rate ratio , 0.9 ; 95 percent confidence limits , 0.6 and 1.6 ) . These data suggest that , in contrast to a natural menopause , bilateral oophorectomy increases the risk of coronary heart disease . This increase appears to be prevented by estrogen-replacement therapy
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 .