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Review

Hormone treatment for mood disorders in women

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Pages 25-34 | Published online: 10 Jan 2014

References

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  • ••This interesting book addresses several issues regarding gender differences in neuroimaging findings and sex differences in HPA axis regulation. There are also very useful chapters on modulation of anxiety by reproductive hormones and clinical implications of hormonal therapies for mood symptoms.
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  • •Preliminary data derived from a large community-based study, focusing on the characteristics of women with 'Pure PMDD' (i.e. met criteria for PMDD and did not have a history of depressive episodes). The authors were able to demonstrate that this subgroup of women were more educated and more frequently had a marital disruption when compared with PMDD subjects who reported previous depressive episodes. Other characteristics (e.g. cigarette smoking) could not be dissociated from past history of depression.
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  • ••A large community-based cohort study,designed to evaluate the relationship between major depression and changes in menstrual and ovarian function. This paper corroborates the prevalence of depression reported by other community-based studies and also supports a relationship between depressive symptoms and marital status, cigarette smoking, nulliparity and premenstrual symptoms.
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  • ••The first well-designed clinical trial of the effects of estrogen replacement therapy for perimenopausal women with clinical depression.
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  • ••To date, this double-blind, randomized, placebo-controlled trial on the antidepressant efficacy of transdermal E2 examined the largest sample of perimenopausal women with major depression. Of women treated with estrogen, 68% showed remission of depression, whereas only 20% responded to placebo. Reassessment after washout period suggested that improvement in mood and in vasomotor symptoms may occur via different pathways.
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  • ••Very useful updated guidelines.
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