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Hormone Replacement Therapy in the Treatment of Perimenopausal Depression

  • Women’s Mental Health (D Rubinow, Section Editor)
  • Published:
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Abstract

The menopause transition is associated with a two to fourfold increased risk in major depressive disorder (MDD) and clinical elevations in depressive symptoms. While the pathophysiological mechanisms underlying this increased risk remain uncertain, ovarian hormone fluctuation is believed to play a role. To the extent that this is the case, hormone replacement therapy (HRT), through its hormone-stabilizing effects, represents a viable antidepressant treatment. The current review summarizes the most recent literature evaluating the efficacy of HRT in treating MDD in peri- and postmenopausal women. In addition, to provide a clinical context in which to interpret this research, the endocrinology and clinical phenomenology related to depression with onset in the menopause transition (D-MT) are discussed. The available evidence suggests that HRT, specifically involving estrogen delivered through a skin patch, is a promising intervention in the treatment of D-MT. However, HRT of any form is an ineffective antidepressant in women who are well into the postmenopausal period.

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Acknowledgments

This work was supported by NIH grant RO1-MH087619. Dr. Gordon is also the recipient of a Postdoctoral Fellowship of the Fonds de la Recherche du Québec–Santé (FRQS).

Compliance with Ethics Guidelines

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Conflict of Interest

Jennifer L. Gordon has received a grant from the Fonds de la Recherche du Québec – Santé (FRQS).

Susan S. Girdler has received a grant from the National Institute of Health, R01-MH087619.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA

    Jennifer L. Gordon

  2. Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, CB# 7160, 101 Manning Drive, Chapel Hill, NC, 27599-3366, USA

    Susan S. Girdler

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  1. Jennifer L. Gordon
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  2. Susan S. Girdler
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Correspondence to Susan S. Girdler.

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This article is part of the Topical Collection on Women’s Mental Health

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Gordon, J.L., Girdler, S.S. Hormone Replacement Therapy in the Treatment of Perimenopausal Depression. Curr Psychiatry Rep 16, 517 (2014). https://doi.org/10.1007/s11920-014-0517-1

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  • DOI: https://doi.org/10.1007/s11920-014-0517-1

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