Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Estrogen has scientific support for its use in treating certain forms of depression, particularly in women during periods of hormonal fluctuation such as perimenopause, postpartum, or menopause. Several studies have demonstrated that estrogen therapy can alleviate depressive symptoms in perimenopausal women, especially those who do not respond to standard antidepressants. For example, randomized controlled trials (RCTs) have shown that transdermal estradiol significantly reduces depression scores in perimenopausal women compared to placebo. The proposed mechanisms include estrogen’s modulation of serotonergic, dopaminergic, and noradrenergic neurotransmission, as well as its neuroprotective and anti-inflammatory effects. However, the evidence is not universal. Large-scale studies in postmenopausal women have yielded mixed results, with some showing no significant antidepressant effect of estrogen therapy, especially when combined with progestins. Guidelines typically do not recommend estrogen as a first-line treatment for depression outside of specific hormonally related cases. Risks associated with hormone therapy, such as increased risk of thromboembolism and certain cancers, must also be considered. In summary, while there is moderate scientific evidence (rated 3/5) supporting estrogen’s use in hormonally mediated depression in women, it is not broadly validated for all types of depression or in all populations.

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