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Hormone Replacement Therapy Can Cause Mood Swings

Review on July 16, 2015

Several studies suggest that the combination of progestin and estrogen in sequential hormone replacement therapy (HRT) can have a negative effect on women's mood, inducing irritability, depression, and anxiety.


If you are thinking about choosing HRT, please keep in mind:

  • Most experts recommend exhausting all the natural alternatives before resorting to hormone therapy, especially where it concerns lifestyle changes (diet, exercise, trigger avoidance, etc.)
  • Also consider alternative medicine, such as herbal remedies.
  • Be aware that there are indications that long-term HRT can increase the risk of breast cancer and other severe illnesses.
  • Because of the associated side effects of HRT, it is only recommended for women with severe and disruptive symptoms.
  • HRT is not for every woman. Discuss with your doctor if HRT is right for you.

Hormone replacement therapy (HRT) is a highly effective and controversial method of treating menopausal symptoms. By increasing and regulating a woman's hormone levels, which fluctuate and drop during menopause, HRT is able to effectively manage - and even completely remove - severe symptoms of menopause in some women.

However, in recent years, HRT has received a lot of criticism for the possible side effects of the treatment. Further research is still being conducted in a variety of areas relating to HRT.

One of these studies, published in The Journal of Clinical Endocrinology & Metabolism, examined the effects of HRT on women's moods. Although estrogen has been found to have a beneficial mental and physiological effect in menopausal women, the study found that when increased levels of estrogen were combined with progestin, mood swings can become a problem.

To investigate this topic, a group of doctors conducted a study on 38 perimenopausal women from December 2000 to November 2001. The participants recorded their symptoms daily during sequential hormone replacement therapy.

HRT can cause mood swings in menopausal women

In the progestin cycle of HRT, women recorded many mood swings, including symptoms such as irritability, especially if the progestin was combined with increased levels of estrogen. Although it was previously thought that progestin is the major cause of mood swings experienced, this study concludes that when combined with progestin, estrogen is a factor in mood swings as well.

Furthermore, women with a history of premenstrual symptoms will most likely suffer from more intense mood swings during HRT, according to a report appearing in the medical journal Climacteric. The same group of researchers followed 106 women during sequential HRT, noting their emotional and physical symptoms in response to the treatment. The study concluded that women who had a history of PMS suffered increased depression, tension, and irritability in response to the progestin and estrogen in HRT as compared to women who had not suffered from PMS.

Before undergoing HRT, women - especially those with a history of PMS - should discuss possible treatment options for  the potential mood swings that may accompany the therapy, or an alternative to HRT.

Sources:
  • "Adult Mood Swings". The Health Center. www.thehealthcenter.info.
  • Dr. Love, Susan, and Karen Lindsey. Dr. Susan Love's Menopause and Hormone Book. New York: Three Rivers Press, 2003.
  • Amin, Zenab, Turhan Canli, and C. Neill Epperson. "Effects of Estrogen-Serotonin Interactions on Mood and Cognition". Behav Cogn Neurosci Rev 2005; 4; 43.
  • "Estrogen Promotes Gender Difference in Brain's Response to Stress". Molecular Psychiatry. www.psycheducation.org.