During the menopause transition, the likelihood that a woman will develop clinically significant depressive symptoms increases 2 to 4 times. New research from the UNC School of Medicine has shown for the first time that hormone replacement therapy during this period can prevent the onset of depression, particularly in certain women.
The research was led by Susan Girdler, PhD, professor of psychiatry and co-director of UNC’s Postdoctoral Training Program in Reproductive Mood Disorders, and David Rubinow, MD, Assad Meymandi Distinguished Professor and Chair of Psychiatry.
A year of hormone therapy can effectively prevent the onset of depressive symptoms for women during the menopause transition.
Girdler called the findings the most exciting of her 25 year clinical research career.
“The fact that we may have the ability to prevent the suffering of women during the menopause transition – which lasts on average five years – is very exciting,” Girdler said.
The randomized controlled trial, conducted over the course of one year, included women with low depressive symptoms who were in perimenopause or early post menopause – ages 45-60. Of the women receiving transdermal estradiol and intermittent micronized progesterone, 17 percent developed clinically significant depression. Thirty-two percent of women in the placebo group became depressed.
Girdler said these results do not mean that every perimenopausal woman should be prescribed hormone therapy, however. Another key finding of the study was a set of baseline predictors that could help physicians understand which of their patients might experience the greatest mood benefit of hormone replacement therapy during the menopause transition.
Women early in the menopause transition will achieve the greatest protective effect from the hormone therapy, Girdler said. And, according to the study, “the beneficial effect of treatment was more apparent in women with a greater number of stressful life events” in the six months preceding study enrollment.
“These predictors can be easily assessed in a clinical interview by asking patients about current stress exposure as well as menstrual bleeding patterns,” Girdler said. “Our findings, if replicated in future studies, could have profound clinical implications.”
The National Institute of Health funded this study.
Dr. Susan Girdler called the findings the most exciting of her 25 year clinical research career.
Additional collaborators included scientists from the UNC School of Medicine, the University of Regina, and the National Institute of Mental Health.
Women early in the menopause transition will achieve the greatest protective effect.
Girdler and collaborators are currently enrolling women aged 45-60 in a follow up trial to assess whether estradiol therapy is beneficial for stabilizing hormone levels and improving mood and stress reactivity. For more information, contact Terry Edwards at Terry_edwards@med.unc.edu or 919-590-0813.