CLEVELAND, Ohio (Sept. 9, 2026)—Mood disturbances—depressed mood, irritability, anxiety, and mental exhaustion—are common during the menopause transition, affecting up to 68% of women. Although hormone therapy (HT) is FDA approved for hot flashes and genitourinary symptoms, its role in managing mood symptoms is less understood. A new study suggests HT may improve mood symptoms in midlife. Results of the study are published online today in Menopause , the journal of The Menopause Society.
The hormone changes commonly experienced during the menopause transition can produce an array of symptoms including hot flashes and night sweats, genitourinary changes, musculoskeletal discomfort, and neuropsychiatric manifestations such as mood and sleep disturbances. These bothersome symptoms have been shown to last 10 or more years, and their severity varies by person, with significant differences documented by race and ethnicity.
Black women, for example, experience hot flashes that are often more severe and longer lasting, whereas Chinese and Japanese women report both lower prevalence and shorter duration of hot-flash episodes. Economic strain and lower education level are associated with increased symptom burden across racial and ethnic groups, suggesting that socioeconomic factors compound these disparities.
Hormone therapy, consisting of systemic estrogen (oral or nonoral) with the addition of a progestogen for endometrial protection in women with a uterus, is recognized as one of the most effective treatment options for some of the most common menopause symptoms. However, there has been conflicting research around the effectiveness of HT on mood symptoms, which are estimated to affect 45% to 68% of menopausal women.
Low estrogen status has been linked to changes in brain structure and activity, whereas estrogen repletion has been associated with improved cortical blood flow, normalized activation patterns, and partial reversal of serotonin imbalance. These findings suggest a biochemical link between estrogen and mood disorders during the menopause transition.
Despite this theorized link, clinical studies of estrogen therapy for mood have yielded mixed results. A new study involving 260 women aimed to document estrogen’s role in mood regulation and the potential of hormone therapy to address mood and sleep changes in menopause. It was designed to additionally address key knowledge gaps by identifying which patients may benefit most from HT.
Based on the results, the researchers concluded that HT, when initiated for FDA-approved indications, resulted in improvements in psychological and sleep symptoms across their cohort.
More specifically, the proportion of patients with severe mood symptoms decreased from 62.3% to 24.6%. Improvement was greatest in those with severe baseline symptoms. Treatment response did not differ by psychiatric history, age, menopause stage, or antidepressant use.
Survey results are published in the article “ Impact of hormone therapy on mood in a real-world clinical setting: a retrospective observational study. ”
“The menopause transition can be a very tumultuous time, and one of the things I hear most often from patients is, “I don’t feel like myself anymore,” and then the tears come. It can be incredibly distressing, affecting personal relationships and interfering with performance at work. Recognizing and addressing mood-related symptoms can make a real difference,” says Dr. Monica Christmas, associate medical director for The Menopause Society.
For more information about menopause and healthy aging, visit www.menopause.org.
The Menopause Society is dedicated to empowering healthcare professionals and providing them with the tools and resources to improve the health of women during the menopause transition and beyond. As the leading authority on menopause since 1989, the nonprofit, multidisciplinary organization serves as the independent, evidence-based resource for healthcare professionals, researchers, the media, and the public and leads the conversation about improving women’s health and healthcare experiences. To learn more, visit menopause.org.
Menopause
10.1097/GME.0000000000000002873
Observational study
People
Impact of hormone therapy on mood in a real-world clinical setting: a retrospective observational study
9-Sep-2026
None reported.