Transdermal oestradiol halves incidence of menopause-related depression
Depressive symptoms were reduced in women assigned to the active treatment vs those on placebo (17.3 percent vs 32.3 percent; p<0.05) one year after treatment with 0.1 mg of oestradiol and 200 mg micronized intramuscular progesterone. Women who were not on hormonal treatment were also more likely to report a score of 16 or greater on the Center for Epidemiologic Studies-Depression (CES-D) scale, which indicates depression, at least once during treatment vs women on oestradiol (odds ratio [OR], 5.3; p<0.01). Those on oestradiol and progesterone treatment who reported high amounts of stressful life events prior to the study had a lower CES-D score vs those on placebo.
The study involved 172 healthy perimenopausal or early postmenopausal women without a diagnosis of major depressive disorders, bipolar, or any other psychotic disorder at enrolment. The women were randomized in a 1:1 ratio to active treatment vs placebo. All women (age, 45–60 years) were not on any background medications.
Transdermal oestradiol was administered at 0.025 mg for 2 weeks, and increased to 0.05 mg for 4 weeks. A dose of 0.1 mg was maintained throughout the study with micronized progesterone 200 mg, administered for 12 days, every 2–3 months. Patients on the control group received placebo.
The benefits of combined oestradiol and progesterone therapy were noted in early perimenopausal women but not in postmenopausal women. History of depression, physical or sexual abuse, and baseline vasomotor symptoms and oestradiol levels did not change the treatment effects.
The researchers said they used 0.1 mg of oestradiol in the study as the dose has been showed to decrease ovulation during menopause transition.