Investigating the Effects of Estradiol or Estradiol/Progesterone Treatment on Mood, Depressive Symptoms, Menopausal Symptoms and Subjective Sleep Quality in Older Healthy Hysterectomized Women: A Questionnaire Study

Abstract

Clinical studies have documented that estrogen treatment often ameliorates mood disturbances and depressive symptoms occurring during the menopausal transition. The relevance of gonadal hormones for mood and well-being in healthy older nondepressed women is less well understood. Fifty-one healthy hysterectomized women (mean age 64) participated in a placebo-controlled double-blind study on the effects of gonadal hormones on cognition. They received either estradiol (2 mg estradiol valerate), estradiol plus progesterone (100 mg micronized progesterone) or placebo. Mood, well being, menopausal symptoms, depressive symptoms and subjective sleep quality were measured at baseline and after 4 and 24 weeks of treatment using three questionnaires. Thirty-five women could be included into the final analysis. Strong increases in estradiol and progesterone levels occurred in response to the treatment. The two hormones, however, had no effects on mood, well-being, menopausal symptoms, sleep quality and depressive symptoms. The current small study suggests that older healthy nondepressed hysterectomized women do not react with positive or negative mood changes to estradiol or estradiol/progesterone treatment.

Exploring Sex and Gender Differences in Sleep Health: A Society for Women's Health Research Report

“…56 Hormone replacement therapy (HRT) seems to alleviate some of the sleep disturbances and improve quality of life; however, the role of HRT in improving sleep quality has been debatable and still continuous to be a major research gap, largely due to lack of concurrence between the study populations and study variables. [57][58][59][60] Recent longitudinal studies have begun to address major questions about the link between menopause and poor sleep in racially diverse populations. For example, Study of Women's Health Across the Nation (SWAN) and the Penn Ovarian Study have incorporated sleep-related items into their questionnaires and performed polysomnographic studies on subgroups.…”

Effect of medroxyprogesterone on depressive symptoms in depressed and nondepressed perimenopausal and postmenopausal women after discontinuation of transdermal estradiol therapy

“…13–18 These studies include a variety of different progestin and estrogen preparations and doses, making direct comparison challenging. Studies using MPA specifically have shown that mood does not worsen on MPA, when co-administered with 17β-estradiol 50–100-mcg/day, 14, 16 conjugated equine estrogens (CEE) 0.625-mg/day, 17 or no estrogen.…”

“…7–12 However, several randomized controlled trials have shown no negative effect of progestin treatment on mood when administered in combination with estrogen therapy (ET), 13–17 or alone. 18 …”

Treatment of Insomnia, Insomnia Symptoms, and Obstructive Sleep Apnea During and After Menopause: Therapeutic Approaches

“…Furthermore, in a study [98] examining the effects of estradiol or estradiol/progesterone treatment on sleep quality, mood, depressive and menopausal symptoms in older healthy women who have undergone hysterectomies, Heinrich and Wolf also reported no significant effects. This placebo-controlled double-blind study examined the effects of estradiol (2 mg), estradiol plus progesterone (100 mg) or placebo at baseline, at 4 weeks and 24 weeks, using three questionnaires.…”