Hormone replacement therapy (HRT) can help ease mood swings in some women by stabilizing estrogen and progesterone levels during perimenopause and menopause, though results differ by individual. Research suggests that restoring hormonal balance may improve irritability, anxiety, and emotional changes linked to this transition.
At SensIQ, Dr. Luke Barr emphasizes evidence-based guidance to help women understand how therapy may influence mood symptoms while also considering safety and alternatives. This article reviews what studies show, practical treatment options, and when to seek professional advice.
Key Takeaways
- Hormone therapy for mood swings may help stabilize emotions during the menopausal transition, but results vary depending on hormones, dosage, and individual medical history.
- Estrogen and progesterone influence brain chemicals linked to mood, and studies show estrogen therapy can improve mood symptoms in some menopausal women.
- HRT offers potential benefits such as reduced mood swings, better sleep, and relief from physical symptoms, but side effects and safety risks must be considered carefully with medical guidance.
- Alternatives like lifestyle strategies, non-hormonal medications, and herbal options such as valerian root can support mood balance for women who cannot or prefer not to use hormones.
- Women considering HRT for menopause anxiety should consult a healthcare provider to weigh treatment options, evaluate risks, and ensure care is tailored to their daily life and medical history.
How Hormone Therapy Affects Mood
Hormone therapy for perimenopause mood swings
Perimenopause often brings mood swings linked to fluctuating estrogen and progesterone during changing menstrual cycles. Some women report mood symptoms such as irritability or depressive symptoms that disrupt daily life. Research suggests hormone therapy may help balance these changes, though results vary¹.
What hormone helps with mood swings?
Studies show estrogen has the most consistent role in regulating mood symptoms, while progesterone can also influence emotional stability². The balance between these hormones is key. Low estrogen is often associated with depression and anxiety in menopausal women.
Estrogen’s role in emotions
Estrogen interacts with brain pathways that regulate serotonin and dopamine, chemicals linked to improved mood and reduced depressive symptoms³. This connection explains why hormone changes during menopause can affect quality of life and lead to emotional shifts.
How long does hormone therapy take to work?
Response times differ. Some women notice improved mood within weeks, while others may need months to evaluate the benefits. Medical history, dose, and type of hormone replacement therapy (HRT) influence how quickly changes occur.
Benefits and Risks of HRT
Pros, cons, and safety of HRT
HRT can reduce symptoms of menopause such as mood swings, hot flashes, and vaginal dryness, leading to improved quality of life⁴. However, side effects can include bloating, breast tenderness, and headaches. Safety depends on personal health conditions, so evaluation by a clinician is essential.
The route of administration also plays a role. Studies show transdermal estrogen may provide mood benefits with a lower risk of metabolic complications compared to oral therapy⁷.
Can HRT improve mood swings quickly?
Some studies show estrogen therapy may improve mood symptoms faster than non-hormonal approaches, though results are not universal⁵. It is important to view hormone therapy as one of several treatment options, not as a guaranteed solution.
Choosing the Right Treatment
Which HRT is best for mood swings?
No single therapy works for all. The best option depends on individual symptoms, medical history, and whether physical symptoms like hot flashes or vaginal dryness are present. A doctor may recommend estrogen alone or combined estrogen and progesterone therapy.
Best HRT for low mood
For women with low mood or depressive symptoms, combined estrogen and progesterone therapy may help stabilize mood swings. Evidence remains mixed, and benefits must be weighed against side effects and risks.
Different hormone therapy options
Treatment options include pills, skin patches, gels, and vaginal creams. Each delivery method has unique pros and cons for menopausal women. Doctors may adjust based on tolerance, convenience, and long-term safety considerations.
Research suggests transdermal estrogen may be particularly beneficial for mood symptoms compared with oral estrogen, although results are not consistent across all studies⁷.
Mood swings and HRT for MTF
HRT is also used in gender-affirming care for MTF individuals. Estrogen therapy in this context may affect mood swings, though treatment goals differ from menopause. Supervision by a specialist is critical to ensure safe use.
Alternatives to Hormone Therapy
Natural hormone replacement therapy
Some women explore plant-based or “bioidentical” hormones marketed as natural hormone replacement therapy. While appealing, studies show results are inconsistent, and safety data are limited. These options should be discussed with a clinician before use.
Lifestyle and stress-reduction strategies
Non-medical steps can also support mood stability. Regular exercise, good sleep hygiene, and mindfulness practices can help reduce mood swings and improve daily life. These are safe first-line strategies for many women.
Non-hormonal treatments for menopause mood changes
Non-hormonal prescription medicines, such as certain antidepressants, can help with menopause mood changes treatment⁶. These may be recommended for women who cannot use hormones due to health conditions.
Herbal support with valerian root
Valerian root has been studied as a complementary option for menopausal women experiencing sleep disturbances and anxiety. Some studies show it may support improved sleep quality and reduce mild mood symptoms, though evidence is mixed and more research is needed⁷.
Valerian should be considered an adjunct, not a replacement for standard medical treatment, and women should consult their doctor before use.
HRT vs non-hormonal mood treatments (comparison)
- HRT: May relieve mood symptoms and physical symptoms of menopause, but carries side effects and risks.
- Non-hormonal treatments: Can reduce mood swings and depressive symptoms, are safer for women with certain medical histories, but may not address hot flashes or vaginal dryness.
- Herbal remedies: Options like valerian root may support relaxation and sleep, but lack the extensive research available for HRT or prescription medications.*
Who Should Consider HRT
Ideal candidates and medical guidance
HRT may be suitable for menopausal women with significant mood symptoms who are otherwise healthy. Dr. Luke Barr stresses the importance of personalized treatment, considering both mood symptoms and physical symptoms.
When hormone therapy may not be safe
Women with a history of breast cancer, blood clots, or certain heart conditions may be advised against hormone therapy. A doctor will review medical history and current health conditions before recommending treatment.
Getting Professional Help
When to seek medical advice
Seek help if mood swings, depressive symptoms, or anxiety interfere with quality of life. A doctor can check whether symptoms of menopause or other health conditions are involved.
Next steps for women considering HRT for menopause anxiety
If you are experiencing mood symptoms during the menopausal transition, discuss HRT for menopause anxiety and treatment options with a qualified provider. At SensIQ, protocols are designed with neurologist oversight to ensure women receive safe, evidence-based guidance tailored to daily life.
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References
- Cleveland Clinic. (2022, September 28). Hormone therapy for menopause symptoms. Cleveland Clinic. https://my.clevelandclinic.org/health/treatments/15245-hormone-therapy-for-menopause-symptoms
- Freeman, E. W., Sammel, M. D., Lin, H., & Nelson, D. B. (2006). Associations of hormones and menopausal status with depressed mood in women with no history of depression. Archives of General Psychiatry, 63(4), 375–382. https://doi.org/10.1001/archpsyc.63.4.375
- Gordon, J. L., Rubinow, D. R., Eisenlohr-Moul, T. A., Leserman, J., & Girdler, S. S. (2012). Estradiol for perimenopausal depression: A randomized controlled trial. Archives of General Psychiatry, 69(3), 293–299. https://doi.org/10.1001/archgenpsychiatry.2011.157
- Maki, P. M., & Joffe, H. (2019). Menopausal mood symptoms: Etiology and treatment. Endocrinology and Metabolism Clinics of North America, 48(3), 421–434. https://doi.org/10.1016/j.ecl.2019.05.001
- National Health Service. (2019, December 23). About hormone replacement therapy (HRT). NHS. https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/about-hormone-replacement-therapy-hrt/
- Soares, C. N., & Frey, B. N. (2010). Challenges and opportunities to manage depression during the menopause transition and beyond. Psychiatric Clinics of North America, 33(2), 295–308. https://doi.org/10.1016/j.psc.2010.01.007
- Taavoni, S., Ekbatani, N., Kashaniyan, N., & Haghani, H. (2013). Effect of valerian root on hot flashes, sleep, and mood in menopausal women: A randomized, triple-blind, controlled clinical trial. Menopause, 20(5), 494–500. https://doi.org/10.1097/GME.0b013e3182712b7a