Girdler added there were two main factors that predicted whether or not women would experience fewer depression symptoms while on hormone therapy. One factor was being in perimenopause (the transition to menopause) and the other was experiencing significant life stress, such as losing a loved one or divorce.
Surprisingly, for women with a past history of major depression — which is a known risk factor for future depression — hormone therapy didn’t appear to lessen the risk of depressive symptoms.
Girdler said normally women going through menopause have a twofold to fourfold higher risk of depression symptoms. There are a number of theories as to why that is, including recent life stress and the idea that some women may be more vulnerable to wildly fluctuating hormones, she explained.
To see if hormone therapy might have an effect on the risk of depression, the researchers recruited 172 women between the ages of 45 and 60. All of the women were either perimenopausal or recently postmenopausal at the start of the study.
Half of the women were aged 51 or older. Seventy-six percent of the women were white, and 19 percent were black. The mean household income was between $50,000 and $80,000.
The women were randomly selected to one of two groups. One group was given an inactive placebo patch to wear. The other group received skin patches that delivered 0.1 milligrams per day of estrogen.
Every three months, women in the estrogen patch group were also given 12 days of the hormone progesterone to ensure that women who still had a uterus shed their uterine lining (endometrium), which helped to offset a potential increase in the risk of endometrial cancer related to estrogen therapy. Hormone therapy was given for a year.
The researchers also asked the women to complete a depression symptom questionnaire. However, they didn’t diagnose any of the women with depression, just “clinically significant depressive symptoms.”
Girdler said that significant fluctuations in hormone variability, as well as stressful life events, can destabilize the cortisol stress axis.
Cortisol is a stress hormone that “helps mobilize the body to respond to stress and to release energy stores so we can prepare for the ‘fight-or-flight’ response. This worked beautifully in cave people, but the problem is we still respond to stress as if there’s a tiger coming after us, but instead we’re just sitting at a computer,” she explained.
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