Hormone therapy may aid in managing depressive symptoms during menopause, study suggests

Hormone therapy (HT) is already recognized as the most effective treatment option for physiologic menopause symptoms such as hot flashes, but a new study is one of the first to suggest that it might also help manage depressive symptoms. It further documented a high rate of depression during menopause. Results of the study are published in Menopause, the journal of The Menopause Society.

Depression and other mood-related symptoms can strike at any time during a woman's life but have been shown to be especially likely during and immediately after the menopause transition. In a new study involving 170 women who were patients at a menopause clinic in Ontario, Canada, there was a high prevalence—62%—of participants who scored as being "depressed." Although these symptoms may not necessarily reach the severity of a major depressive disorder, they still could significantly affect quality of life and relationships.

To date, the effectiveness of HT to effectively manage hot flashes (technically known as vasomotor symptoms) has been well documented. However, its ability to address mood-related symptoms is less established. This new study from Canada sought to correct that problem.

Hormone influences on neurotransmitter-receptor pathways, which regulate mood during and after the menopause transition, are thought to play a role in depressive symptoms. In addition, the domino theory suggests that the toll of physiologic symptoms experienced during menopause, such as hot flashes and an array of genitourinary problems, could also contribute to adverse moods.

As part of their study, researchers attempted to determine whether the stage of menopause contributed to an increased risk of depression, but no association was found, although a lower education level (high school or less) and younger age did show a direct correlation.

The addition of progestin to the HT regimen did not have a significant effect on overall effectiveness. Additionally, although women who went through natural menopause experienced significant improvements with regard to their depressive symptoms, women who experienced iatrogenic menopause (surgical or chemotherapy-based) did not have similar improvements.

On the basis of these results, the researchers concluded that HT—whether used alone or in conjunction with antidepressants—can improve not only hot flashes but also depressive symptoms commonly associated with menopause.

Survey results are published in the article "Does menopause hormone therapy improve symptoms of depression? Findings from a specialized menopause clinic."

"This study showed a beneficial effect of hormone therapy on mood symptoms during menopause when used alone and a synergistic effect when used in combination with antidepressants. It also highlights the high prevalence of mood symptoms during this transition and the need to address women's symptoms holistically rather than having a singular focus on hot flash management," says Dr. Stephanie Faubion, medical director for The Menopause Society.