Many women are inappropriately prescribed antidepressants or anti-anxiety medications to help manage low mood, anxiety and emotional changes during perimenopause and menopause.

Research from Newson Research suggests that for many, hormone treatments address the root cause – reducing the need for antidepressants altogether.

Mental health impact of menopause

Fluctuating and falling hormone levels during midlife are known to negatively affect mood and wellbeing. Despite this, around one in three perimenopausal women are offered antidepressants, even when they do not meet the criteria for clinical depression. Guidelines state that hormone replacement therapy (HRT) is first-line treatment for hormone-related psychological symptoms.

The study looked at 1,081 perimenopausal and menopausal women who were already taking antidepressants or anxiolytics when they first attended the Newson Clinic between October 2023 and May 2024. Their average age was just under 52. All were prescribed HRT, and researchers followed up after three months to see whether their mental health medications had changed.

The results, presented at the International Society for the Study of Women’s Sexual Health annual meeting in California, were striking. Overall,39% of women either reduced or completely stopped their antidepressant oranti-anxiety medication after starting hormone treatment.

In women using estradiol with or without progesterone, about one in four reduced or discontinued their medication. However, outcomes were even better for those who also received testosterone alongside standard hormone treatment. In this group, 40% reduced or stopped their antidepressants, with nearly three in ten discontinuing them entirely.

Additional benefits

The findings suggest that adding testosterone provides additional benefits for psychological symptoms such as low mood, motivation and emotional wellbeing.

Researchers say this supports the idea that for some women, mood changes in midlife are driven primarily by hormone deficiency rather than primary depression. Treating that deficiency directly by prescribing hormones can improve symptoms so that women can come off medications that are often associated with side effects and long-term risks.

Importance of individualised care

While antidepressants can be beneficial for some people with clinical depression, the authors emphasise the importance of recognising perimenopause and menopause-related mood symptoms and considering hormone treatments.

They conclude that wider awareness of the psychological benefits of hormones would help many women avoid unnecessary long-term use of antidepressants – and receive individualised hormone treatments that better reflect the hormonal changes.

Download a poster summarising Newson Research’s findings below.