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 .
Hormonal treatment and psychological function during the menopausal transition: an evaluation of the effects of conjugated estrogens/cyclic medroxyprogesterone acetate.
OBJECTIVE To investigate the effect of hormone treatment on  psychosocial distress of women during the menopausal transition ( aged 40 - 52 years , still menstruating and with minor symptoms ) , in a study carefully design ed to reduce bias and placebo effect . METHODS The study was r and omized , controlled by placebo , blinded to the subject , investigators and biostatistician , crossed-over after 6 months , and evaluated by a 77-item question naire every month for 12 months . The medication tested was continuous conjugated estrogens ( Premarin ) and cyclic medroxyprogesterone acetate ( Provera ) . RESULTS Of an eligible 105 apparently healthy women , recruited by advertisement , 83 completed the question naires for the study . R and omization was successful . While there was a substantial variation over time in the change of scores for all the psychosocial outcomes , there was no significant difference between active and placebo treatment when order of treatment allocation was ignored . However , a strong and consistent effect of the order of treatment allocation for many of the scores was found ; in particular , the effect of active treatment was substantially stronger when it was administered second . Positive effects of active treatment were found for the score for the overall symptom rating test ( p < 0.009 ) and its components of depression and feeling of inadequacy ( p = 0.011 ; p = 0.001 , respectively ) . CONCLUSIONS The use of hormones , given as a continuous estrogen and cyclic progestogen formulation after a formal calibration/run-in period , may have a beneficial effect on psychosocial distress experienced by women towards the end of their reproductive function
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 .