More than half of all women initiating treatment with hormone therapy will stop within the first year of treatment, most often because of side effects. Mood disturbance is a relatively common side effect that occurs with hormone therapy, and previous studies have suggested that progestins in the combined hormone preparations are responsible for these negative mood effects.
A recent study from Dr. Maria Rogines-Velo and Dr. Hadine Joffe at the CWMH suggests that progestin therapy does not cause significant mood changes in women. This study included peri- and postmenopausal women between the ages of 40 and 60. Medroxyprogesterone acetate (MPA; a synthetic variant of human progesterone) at 10 mg/day was administered for 14 days (for endometrial protection) after women completed at least 8 weeks of treatment with 17[beta]-estradiol (0.1 mg/day).
For the 24 non-depressed and 14 depressed women treated with MPA, the Beck Depression Inventory scores did not change during MPA treatment. The results of this study indicate that MPA does not increase depressive symptoms in peri- and postmenopausal women treated sequentially with estradiol and then MPA, even among the women receiving estrogen for the treatment of depression.
This is the first study to investigate the effects of MPA on mood in a depressed population. These findings suggest that MPA can be used safely in both depressed and in non-depressed women and that progestins should not be withheld from depressed women because of concerns that the progestin will exacerbate their depressive symptoms.
Ruta Nonacs, MD PhD
Rogines-Velo MP, Heberle AE, Joffe H. Effect of medroxyprogesterone on depressive symptoms in depressed and nondepressed perimenopausal and postmenopausal women after discontinuation of transdermal estradiol therapy. Menopause. 2012; 19(4):471-5.