HRT (Hormone Replacement Therapy) and Mental Health in Menopause

Decreasing estrogen:

As estrogen decreases in the perimenopausal period, many symptoms may occur: hot flashes, irritability, vaginal dryness, sleep disorders, etc. With severe symptoms, often doctors will recommend hormone replacement therapy (HRT), usually estrogen, oral or insertable in order to reduce severe symptoms.   

A lot of research has been conducted about the use of HRT for menopausal symptoms. For recommendations for the use of HRT for severe symptoms during menopause, please consult your doctor; your doctor will help you evaluate your risk and benefits for the use of HRT.  For more in-depth and up-to-date information about the types of HRT and its use in menopause, visit the Society of Obstetricians and Gynaecologists of Canada’s website. 

There is some debate as to whether HRT can help women who struggle with depression; however, though there may be some evidence to suggest that HRT has some antidepressant effects in some menopausal women with severe symptoms, HRT is not approved to treat perimenopausal depression and the conventional therapy is antidepressants and psychotherapy such as CBT.1 

Menopausal symptoms & depression:

However, menopausal symptoms can complicate, co-occur, and overlap with depression. If you are concerned that you may be suffering from depression or anxiety during menopause, you can take these 3 steps to improve your mental health: 

1. Complete a depression screener or anxiety screener to take a snapshot of your mental health.

2. Start online CBT therapy or online IPT therapy.
 

3. Talk to your doctor about HRT.

Further Information

References:
 

• 1(Guidelines for the evaluation and treatment of perimenopausal depression: summary and recommendations: Menopause 2018 10;25(10): 1069-1085.)