Associations between psychological well-being, mental health, and hormone therapy in perimenopausal and postmenopausal women: results of two population-based studies

Objective: A proportion of women experience depressive and anxiety symptoms and/or disorders in connection with the menopausal transition. Estrogen-only therapy has been reported to have beneficial effects on mental health, but the effects of combined hormone therapy (HT) on mental health are less clear. We studied the associations between HT use and psychopathology in perimenopausal and postmenopausal women. Methods: Data on women who participated in the Health 2000 Survey and the National FINRISK Surveys in Finland were analyzed. Results: An association between current HT use and psychiatric diagnosis in the previous 12 months was found. In addition, HT use was associated with recent self-reported diagnosis of depression and with depressed mood (FINRISK), as well as with major depressive disorder and anxiety disorder (Health 2000). Associations with the following symptoms were found: nervousness, frightening thoughts, nightmares, and headache (FINRISK), feelings of depression (FINRISK and Health 2000), and unhappiness (Health 2000). No differences between different routes of administration or types of HT emerged. Conclusions: Current use of HT in perimenopausal and postmenopausal women is associated with worse psychological well-being and mental health than in women not using HT. It is important to identify women in need of psychiatric support at the time of the menopausal transition.