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 .
A comparison of the effect of estrogen with or without progesterone on mood and physical symptoms in postmenopausal women.
Using a r and omized , placebo-controlled design , this study assessed the effects of estrogen alone ( ES ) or in combination with cyclic progesterone ( EP ) on daily ratings of mood and physical symptoms before and after 6 months of daily hormone treatment . Fifty-four postmenopausal women were recruited from the community at large and specifically selected as being asymptomatic at the time of enrollment and without significant psychiatric history . Ratings were obtained every day for 30 days prior to treatment and again every day during the last 30 days of treatment . Results revealed that when compared with pretreatment levels , women r and omized to EP ( n = 16 ) exhibited statistically significant increases in daily depression , cramping , and breast tenderness and a marginally significant increase in daily anxiety . However , these increases were mild , not clinical ly significant , and did not interfere with normal functioning . Women r and omized to ES ( n = 20 ) showed no significant change in daily mood measures , although they did experience an increase in breast tenderness with estrogen . A significant placebo ( n = 18 ) effect was observed , as there was a reliable reduction in daily irritability ratings ( p < 0.05 ) with placebo . These findings suggest that for most postmenopausal women , the use of hormones will not be associated with clinical ly significant changes in mood or physical symptoms , which weighs favorably into the cost-benefit ratio for women considering hormone 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 .