Transdermal oestradiol and testosterone therapy for menopausal depression and mood symptoms: Retrospective cohort study

Glynne, S, Kamal, A, McColl, L, Newson, L, Reisel, D, Mu, E, Hendriks, O ORCID: 0009-0005-0990-318X, Saini, P ORCID: 0000-0002-4981-7914, Gurvich, C and Kulkarni, J (2025) Transdermal oestradiol and testosterone therapy for menopausal depression and mood symptoms: Retrospective cohort study. British Journal of Psychiatry, 228 (5). pp. 409-418. ISSN 0007-1250

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Abstract

Background Psychological symptoms in perimenopause and early menopause are common. The impact of menopausal hormone therapy (MHT) on menopausal mood symptoms is unclear. Aims To assess the impact of 17β-oestradiol ± micronised progesterone or the levonorgestrel-releasing intrauterine device, and/or transdermal testosterone, on depressive and anxiety symptoms in peri- and postmenopausal women. Method A real-world retrospective cohort study set in the largest specialist menopause clinic in the UK. The Meno-D questionnaire measured mood-related symptoms. Results The study included 920 women: 448 (48.7%) perimenopausal, and 435 (47.3%) postmenopausal. Following initiation/optimisation of MHT, mean Meno-D scores decreased by 44.59% (95% CI -46.83% to -42.34%, P < 0.001) after average 107 days follow-up. Mood symptoms significantly improved (P < 0.01 per symptom). Improvement occurred in peri- and postmenopausal women. All MHT regimens improved mental health including both progestogen types (body-identical progesterone and levonorgestrel-releasing intrauterine device), MHT initiation strategy (oestradiol ± a progestogen versus oestradiol ± a progestogen and testosterone, 45.38 v. 48.53%, respectively, P = 0.47) and MHT optimisation strategy (MHT users treated with a higher oestradiol dose versus testosterone added versus both a higher oestradiol dose and testosterone, 34.70, 43.93 and 43.25%, respectively, P = 0.38). Conclusions Use of menopausal hormone therapy was associated with significant improvement in mood in peri- and postmenopausal women. Prospective studies and randomised clinical trials are needed to assess the effects of different regimens in different patient populations over longer time periods.

Item Type:	Article
Uncontrolled Keywords:	Menopause; menopausal hormone therapy; body-identical hormones; mood; mental health; Humans; Testosterone; Estradiol; Levonorgestrel; Progesterone; Hormone Replacement Therapy; Administration, Cutaneous; Retrospective Studies; Depression; Anxiety; Menopause; Adult; Aged; Middle Aged; Female; Menopause; body-identical hormones; menopausal hormone therapy; mental health; mood; Humans; Female; Retrospective Studies; Testosterone; Middle Aged; Estradiol; Administration, Cutaneous; Menopause; Depression; Adult; Levonorgestrel; Anxiety; Aged; Progesterone; Hormone Replacement Therapy; 3215 Reproductive Medicine; 32 Biomedical and Clinical Sciences; 3202 Clinical Sciences; Brain Disorders; Contraception/Reproduction; Menopause; Mental Illness; Depression; Estrogen; Aging; Behavioral and Social Science; Clinical Research; Clinical Trials and Supportive Activities; Mental Health; Women's Health; 3 Good Health and Well Being; Humans; Female; Retrospective Studies; Testosterone; Middle Aged; Estradiol; Administration, Cutaneous; Menopause; Depression; Adult; Levonorgestrel; Anxiety; Aged; Progesterone; Hormone Replacement Therapy; 11 Medical and Health Sciences; 17 Psychology and Cognitive Sciences; Psychiatry; 32 Biomedical and clinical sciences; 42 Health sciences; 52 Psychology
Subjects:	B Philosophy. Psychology. Religion > BF Psychology R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions:	Psychology (from Sep 2019)
Publisher:	Cambridge University Press on behalf of Royal College of Psychiatrists
Date of acceptance:	28 March 2025
Date of first compliant Open Access:	27 August 2026
Date Deposited:	27 Aug 2026 08:31
Last Modified:	27 Aug 2026 08:31
DOI or ID number:	10.1192/bjp.2025.101
URI:	https://researchonline.ljmu.ac.uk/id/eprint/29204

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