Hormone Therapy Appears to Reduce Depression Risk in Perimenopausal Women

By Amy Orciari Herman

Edited by Susan Sadoughi, MD, and Richard Saitz, MD, MPH, FACP, DFASAM

Transdermal estrogen combined with oral progesterone lowers the risk for depression in perimenopausal women, suggests a small trial in JAMA Psychiatry.

Some 170 nondepressed perimenopausal or early-postmenopausal women were randomized to receive transdermal estradiol (0.1 mg/day) or matching placebo for 12 months; oral micronized progesterone (or matching placebo) was also given for 12 days every 3 months.

Hormone recipients were significantly less likely than placebo recipients to develop clinically significant depressive symptoms (17% vs. 32%). This benefit seemed limited to women in early perimenopause. Additionally, the benefits were greater among women who had recently experienced stressful life events. Hormone recipients had more spotting, heavy bleeding, and prolonged bleeding than did placebo recipients.

The researchers say that if larger studies confirm their results, providers “may consider” such treatment to help prevent depressive symptoms in this patient population. Editorialists, meanwhile, call the results “provocative” but caution that they don’t support a change in current hormone therapy guidelines.