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Associations between psychological well-being, mental health, and hormone therapy in perimenopausal and postmenopausal women: results of two population-based studies

Toffol, Elena MD1; Heikinheimo, Oskari MD, PhD2; Partonen, Timo MD, PhD1

doi: 10.1097/gme.0b013e318278eec1
Original Articles

Objective A proportion of women experience depressive and anxiety symptoms and/or disorders in connection with the menopausal transition. Estrogen-only therapy has been reported to have beneficial effects on mental health, but the effects of combined hormone therapy (HT) on mental health are less clear. We studied the associations between HT use and psychopathology in perimenopausal and postmenopausal women.

Methods Data on women who participated in the Health 2000 Survey and the National FINRISK Surveys in Finland were analyzed.

Results An association between current HT use and psychiatric diagnosis in the previous 12 months was found. In addition, HT use was associated with recent self-reported diagnosis of depression and with depressed mood (FINRISK), as well as with major depressive disorder and anxiety disorder (Health 2000). Associations with the following symptoms were found: nervousness, frightening thoughts, nightmares, and headache (FINRISK), feelings of depression (FINRISK and Health 2000), and unhappiness (Health 2000). No differences between different routes of administration or types of HT emerged.

Conclusions Current use of HT in perimenopausal and postmenopausal women is associated with worse psychological well-being and mental health than in women not using HT. It is important to identify women in need of psychiatric support at the time of the menopausal transition.

From the 1Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland; and 2Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.

Received September 24, 2012; revised and accepted October 12, 2012.

Funding/support: E.T. received financial support from the National School of Clinical Investigation (Helsinki, Finland). The funding source had no role in study design, data handling, or manuscript preparation.

Financial disclosure/conflicts of interest: None reported.

Address correspondence to: Elena Toffol, MD, Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, PL30, 00271 Helsinki, Finland. E-mail:

© 2013 by The North American Menopause Society.