Section - Video Lectures

05. Estrogen Withdrawal, Hormone Therapy, and Perimenopausal Depression

Published on April 1, 2020 Expired on April 1, 2024 DOI: 10.64239/PI-VL2905

Vivien K. Burt, M.D., Ph.D.

Professor Emeritus of Psychiatry & Founder and Consulting Director - David Geffen School of Medicine at UCLA & Women’s Life Center of the Resnick UCLA Neuropsychiatric Hospital

Key Points

Women who discontinue hormone therapy are at an increased risk of depressive symptoms if prior treatment during perimenopause was successful.
Hormone therapy reduces vasomotor symptoms and prevents the onset of depression in perimenopausal women exposed to life stressors.

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Slides and Transcript

Slide 1 of 6

Most recently, there have been a number of refined studies that have looked at the role of estrogen in perimenopausal depression.

Estrogen Withdrawal, Hormone Therapy, and Perimenopausal Depression Slide 1 of 6

Slide 2 of 6

In this first study, Peter Schmidt and colleagues at the NIMH compared postmenopausal women with and without histories of depression as they went through the perimenopausal transition. They found that women with past perimenopausal depression who had responded to hormone therapy experienced a recurrence of depression when estrogen was reintroduced and then again withdrawn. But women who did not have perimenopausal depression and were given estrogen which was then withdrawn did not become depressed. This suggested that women with past perimenopausal depression may in fact be susceptible to recurrent depression when hormone therapy is discontinued. So it’s something for people to think about that if women had past perimenopausal depression, they are particularly probably susceptible to a recurrence if they were on hormones and these hormones were discontinued.

References:

Studd, J. (2016). HRT should be considered as first line therapy for perimenopausal depression: FOR: Estrogens are the first line treatment for perimenopausal women. BJOG: An International Journal of Obstetrics & Gynaecology, 123(6), 1011-1011.

Estrogen Withdrawal, Hormone Therapy, and Perimenopausal Depression Slide 2 of 6

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06. Guidelines, Risks, and Benefits of Hormone Therapy