Can hormone replacement therapy - HRT - reduce the psychological problems I am experiencing?

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 request 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.

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