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 .
Efficacy of estradiol for the treatment of depressive disorders in perimenopausal women: a double-blind, randomized, placebo-controlled trial.
BACKGROUND Results of previous studies suggest that estrogen improves somatic and mild depressive symptoms experienced by perimenopausal women . This study investigated the efficacy of 17beta-estradiol for the treatment of clinical ly significant depressive disorders in endocrinologically confirmed perimenopausal women . METHODS Perimenopausal women ( aged 40 - 55 years , with irregular menstrual periods and serum concentrations of follicle-stimulating hormone > 25 IU/L ) , meeting criteria for major depressive disorder , dysthymic disorder , or minor depressive disorder , according to DSM-IV , were r and omized to receive transdermal patches of 17beta-estradiol ( 100 microgram ) or placebo in a 12-week , double-blind , placebo-controlled study . A 4-week washout period followed the 12-week treatment phase . Outcome measures were the Montgomery-Asberg Depression Rating Scale and Blatt-Kupperman Menopausal Index scores . RESULTS Fifty women were enrolled in the study ; 26 met DSM-IV criteria for major depressive disorder , 11 for dysthymic disorder , and 13 for minor depressive disorder .  Remission of depression was observed in 17 ( 68 % ) women treated with 17beta-estradiol compared with 5 ( 20 % ) in the placebo group ( P = .001 ) . Subjects responded similarly to estradiol treatment , regardless of DSM-IV diagnosis . Patients treated with estradiol sustained antidepressant benefit of treatment after the 4-week washout period , although somatic complaints increased in frequency and intensity . Treatment was well tolerated and adverse events were rare in both groups . CONCLUSION Transdermal estradiol replacement is an effective treatment of depression for perimenopausal 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 .