Menopause is a significant event for women as they enter their 40’s and 50’s. During perimenopause (the time just prior to menopause), women often notice many biological, psychological and social changes. In particular, some women experience depressive symptoms during menopause that are severe enough to warrant antidepressant medication. Response to antidepressant medication in menopausal women may depend on the level of estrogen in their blood. Researchers have been successful in linking the negative effects of estrogen deficiency (i.e., a lack of estrogen in the body) to the skeletal (e.g. bone density loss) and vasomotor systems (e.g. hot flashes). However, less information is available about how declining levels of estrogen influence mood and memory.

Although some women respond fully to medication, others only partially respond, and continue to experience depressive symptoms that negatively impact their quality of life. We are investigating whether estrogen will help the women who respond only partially to antidepressant medication. We will also examine the effects of different doses of estrogen.

The study will last 9 weeks, during which participants will take varying doses of estrogen. Participants will be paid up to $60.00 for participation in the study, and will be contributing to better understanding of women’s health needs.

An estimated 1.3 million women will enter menopause each year. During this transition, many women experience depressive symptoms, hot flashes, memory impairment, poor sleep and other symptoms. Hormone therapy may relieve many of these symptoms; however, there are also risks associated with this treatment. One strategy of hormone replacement (long-term combined hormone treatment) may be associated with increased risk of cancer, heart disease, or dementia. On the other hand, some data suggest that short-term replacement with estrogen alone (without other hormones) may have benefits for improving mood, quality of life, and cognition in women suffering from treatment-resistant menopausal depression. Limited data suggest that estrogen augmentation may enhance the effectiveness of antidepressant medication in menopausal depression. There are few guidelines on how to optimize antidepressant administration with estrogen. There are considerable fluctuations in women’s biological response to estrogen wherein a starting dose may be inadequate for some women while in others an average dose results in prominent side effects. The purpose of this study is to assess different doses of estrogen on depressive symptoms and memory in women with menopausal depression. Because this is a short-term, low-dose regimen of a single hormone, it is reasonable to assert that the study will not be associated with the risks of long-term treatment with combined hormones.