Can hormone replacement therapy (HRT) reduce the psychological problems that I am experiencing?
Psychological problems including depression and anxiety are often encountered around the time of the menopause and it would certainly seem reasonable to try HRT to assess potential benefit. Psychiatrists distinguish between depressed mood and depressive disorder. Despondency, low spirit and demoralisation are common symptoms that most of us have experienced at one time or another usually as a reaction to one of life's stresses. Depressive disorder is more severe. Loss symptoms, including loss of energy, appetite, interest, libido (sex drive), and the capacity to enjoy life are typical of depressed mood. Depressed mood may respond to HRT but psychiatrists would caution that depressive disorder is generally outside hormonal influence.
Hormone replacement therapy can reduce sleep disturbance, insomnia, increase energy and restore that feeling of well-being. The balance may be redressed so that a woman comes out of despair into a world where she can cope and begin to enjoy her life again. hormone replacement therapy, however, cannot cure all the stresses and strains of life. One study found that a significant number of women had unrealistic expectations from HRT.
In practice, it may be difficult to predict who will respond to HRT and who will not. There are times when one is sufficiently anxious about a patient's mental state that it seems appropriate to re quest early psychiatric assessment. However, there is little to be lost by a 'trial' of HRT and perhaps much to be gained. Any improvement is to be welcomed. Adjustment of dosage may provide further benefit. A double-blind (placebo & controlled trials) study found that with oestrogen replacement adaptation to life improved and depression showed signs of lifting and another study concluded that psychological well-being is improved by HRT.
A controlled study (placebo & controlled trials) evaluating HRT for its effect on psychological symptoms found significant improvement in anxiety and depression with oestradiol or combined oestradiol and testosterone implants. This improvement only occurred in women approaching the menopause.
Related Medical Abstracts - Click on the paper title:-
- Mood scores in relation to hormone replacement therapies during menopause: a prospective randomized trial. (2005-01)
- Influence of a continuous combined HRT (2 mg estradiol valerate and 2 mg dienogest) on postmenopausal depression. (2004-01)
- Clinical assessment and quality of life of postmenopausal women treated with a new intermittent progestogen combination hormone replacement therapy: a placebo-controlled study. (2003-01)
- Efficacy of estradiol for the treatment of depressive disorders in perimenopausal women: a double-blind, randomized, placebo-controlled trial. (2001-01)
- A scheme of combined oral contraceptives for women more than 40 years old. (2001-02)
- Has the impact of hormone replacement therapy on health-related quality of life been undervalued? (2000-01)
- Estrogen replacement in perimenopause-related depression: a preliminary report. (2000-02)
- Hormone replacement therapy, sleep Quality and psychological wellbeing (1995)
- Estrogen improves psychological function in asymptomatic postmenopausal women (1991)
Please click on the required question.
- 1 HRT help me with the psychological difficulties that I am experiencing around?
- 2 HRT help my mental ability?
- 3 Can HRT reduce my chance of developing heart disease?
- 4 How does HRT protect against coronary heart disease?
- 5 If I am at particular risk of heart disease, can HRT still help?
- 6 Do progestogens taken in combination with oestrogen replacement therapy have an adverse effect on heart protection?
- 7 How long should HRT be taken to reduce the risk of heart disease?
- 8 Is there any evidence that HRT will protect my bones?
- 9 Would the dose (strength) of my HRT influence its ability to protect my bones?
- 10 Are there other treatments apart from HRT for osteoporosis?
- 11 Would HRT help my skin?
- 12 Can hormone replacement therapy cure all my menopausal symptoms?
- 13 How prevalent is cancer of the breast?
- 14 What factors influence the chance of breast cancer developing?
- 15 What is the relationship between HRT and breast cancer?
- 16 I have benign breast disease. Can I take HRT?
- 17 Does a history of breast cancer mean that HRT is absolutely contraindicated?
- 18 If I started HRT early (aged 30 to 45), does this influence my chance of developing breast cancer?
- 19 Does hormone replacement therapy increase the risks of cancer of the womb?
- 20 I have had endometrial cancer and now have menopausal problems. Can I take HRT?
- 21 Does HRT have a relationship to ovarian cancer?
- 22 How does HRT relate to a blood clot (DVT - deep venous thrombosis or pulmonary embolism)?
- 23 I have varicose veins. Can I take HRT?
- 24 Should HRT be discontinued before I have a major operation or leg surgery?
- 25 Does HRT increase life-expectancy?
- 26 I am still seeing periods. Could HRT have any benefits for me?
- 27 I have been told that I have fibroids. Can I take HRT?
- 28 What happens if I decide not to take HRT?
- 29 Doctors seem to promote HRT but the media cause me anxiety. Who is right?
- 30 Support Groups.
Thank you for choosing to visit us.
This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.
I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.
