A comparison of the effect of estrogen with or without progesterone on mood and physical symptoms in postmenopausal women

Using a randomized, placebo-controlled design, this study assessed the effe cts of estrogen alone (ES) or in combination with cyclic progesterone (EP) on daily ratings of mood and physical symptoms before and after 6 months of daily hormone treatment. Fifty-four postmenopausal women were recruited fr om the community at large and specifically selected as being asymptomatic a t the time of enrollment and without significant psychiatric history. Ratin gs were obtained every day for 30 days prior to treatment and again every d ay during the last 30 days of treatment. Results revealed that when compare d with pretreatment levels, women randomized to EP (n = 16) exhibited stati stically significant increases in daily depression, cramping, and breast te nderness and a marginally significant increase in daily anxiety. However, t hese increases were mild, not clinically significant, and did not interfere with normal functioning. Women randomized to ES (n = 20) showed no signifi cant change in daily mood measures, although they did experience an increas e in breast tenderness with estrogen. A significant placebo (n = 18) effect was observed, as there was a reliable reduction in daily irritability rati ngs (p < 0.05) with placebo. These findings suggest that for most postmenop ausal women, the use of hormones will not be associated with clinically sig nificant changes in mood or physical symptoms, which weighs favorably into the cost-benefit ratio for women considering hormone replacement therapy.