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    Did you know an estimated 20% of women will experience depression during menopause? If you’re experiencing depression symptoms during menopause, HRT may be able to help. Estrogen injections may help increase the serotonin in your body, which may help boost your mood and reduce your risk for depression. 

    woman smiling with arms open because HRT helped boost her mood during menopause

    If you’re feeling depressed during menopause, treatments are available! Even HRT can help increase serotonin to help boost your mood.

    Depression is one of the most common mental health issues in the United States, and women are about twice as likely to experience it than men. In some cases, this can be attributed to changes in serotonin due to fluctuating or low estrogen levels. For example, premenstrual syndrome, premenstrual dysphoric disorder, and postpartum depression have all been linked to estrogen levels. Women who experience these or have been diagnosed with depression in the past may be more likely to experience depression during menopause. However, it’s important to understand that help is available!

    HRT May Help Relieve Menopausal Depression

    There have been many studies that explore how hormones may affect depression during menopause. In many cases, hormone replacement treatment has helped women feel better and improve their mood during menopause. These treatments help replace and stabilize your hormones as your body begins to transition to post-menopause. This may help alleviate your depression symptoms if they’re tied to the hormonal changes you experience during menopause. In fact, many doctors see hormones as a first line treatment for menopausal depression because of the link between estrogen and mood.

    Estrogen may play a complex role in depression for women. For instance, there are several areas of the brain that are rich in estrogen receptors, such as the amygdala, the hypothalamus, and the hippocampus. Each of these parts of the brain plays a role in regulating your emotions. They all also have estrogen receptors. In fact, some studies have found that women using hormones for menopause symptoms may have larger hippocampuses. 

    However, another potential link between low estrogen levels during menopause and depression is its relationship with serotonin. Serotonin is an important chemical for mood and estrogen levels may play a key role in your serotonin levels during menopause.

    Why Might Menopause Bring on Depression?

    Menopause is complex, so there are many different reasons why you might experience depression during this time. Low levels of estrogen and serotonin may contribute to depression during menopause. 

    First, it’s important to define depression. You might think of sadness when you think of depression, and that can definitely play a role! However, sadness doesn’t always mean depression. For instance, you might feel sad when you’re under a lot of stress, or not getting a promotion you’ve been vying for. It’s also completely normal to feel sad when your children leave the nest. This type of sadness, while unpleasant, is normal. It typically doesn’t last long periods of time and you can often find relief from talking to someone, journaling, or even crying. 

    Depression, on the other hand, is a mental health problem that can last for long periods of time and may interfere with your life. For example, you may not enjoy the activities that you used to, or have a hard time focusing on work. 

    Generally speaking, if your low mood lasts for more than two weeks, it’s important to talk to a health care provider about your symptoms. 

    Some symptoms of depression include:

    • Low mood for most of the day, almost every day
      • Feelings of sadness, hopelessness, or irritability
    • Appetite changes
    • Sleep changes
    • Fatigue
    • Lack of motivation
    • Difficulty concentrating or making decisions
    • Lost interest in activities you previously enjoyed

    If you’ve noticed any of these symptoms for longer than two weeks, then it’s time to book an appointment with one of our health care providers. Hormone levels might be contributing to your depression during menopause. 

    How Estrogen Affects Serotonin

    One of the main culprits for many different menopause symptoms is estrogen. For some women, low or fluctuating estrogen levels may increase the risk for depression. Estrogen may even impact your serotonin levels, which may explain why many women find HRT helps their menopausal depression symptoms.

    Researchers are still studying the complex relationship between estrogen and serotonin. However, estrogen may increase serotonin levels in your body, the number of serotonin receptors you have, and even how quickly and effectively the receptors use serotonin. Therefore, fluctuating or low estrogen during menopause may decrease serotonin in your brain and lead to low mood or even depression.

    What is Serotonin?

    Many of us have heard of serotonin, but a lot of us don’t know exactly what it is. Serotonin is a hormone that plays a really crucial role in your mood, among other things. It’s often called the “feel good” hormone, and many antidepressant medications work by increasing the amount of serotonin in your body.

    Serotonin can affect many different health factors, including:

    • Mood
    • Sleep
    • Social behavior
    • Sexual desire

    Essentially, serotonin is a pretty important chemical for your brain. Low serotonin levels may be linked to clinical depression. Therefore, there may be a link between low estrogen and serotonin levels during menopause and depression. 

    Estrogen HRT May Help Increase Serotonin to Help Fight Depression

    During menopause, your estrogen levels can fluctuate wildly and become much lower than your body is used to. This is because your ovaries are slowly transitioning to the post-menopausal state where they produce significantly less estrogen. These hormone changes can also wreak havoc on your serotonin levels. 

    If you’re experiencing depression during menopause, hormone imbalance treatment with estrogen (and progesterone if you still have your uterus) may help increase serotonin and decrease your risk for depression. Many women start hormone therapy to help with physical symptoms like hot flashes, but hormone replacement may also help alleviate emotional symptoms like depression symptoms and mood changes. Therefore, if you’ve noticed some of the signs of depression during your transition into menopause, consider talking to one of our providers about treatment options. 

    Other Possible Treatments for Depression During Menopause

    However, keep in mind that even if you’re not a good candidate for HRT, there are still treatments available! You don’t need to suffer through depression, and there’s no shame in seeking help when you need it. Depression is a serious health condition, so it’s important to address it as soon as possible. If you’re not a good candidate for hormones, some other treatment options include lifestyle changes, talk therapy, and antidepressant medications. In some cases, you might even experience depression because of other common health conditions, like an untreated thyroid disorder. Therefore, if you think you’re suffering from depression, talk to one of our health care providers about treatment options that suit your situation. 

    HRT and Treatments for Other Health Conditions at HerKare

    At HerKare, we’re a women’s clinic here to help you address your hormonal and overall wellness. We offer individualized care based on your needs. Whether you’re dealing with menopause symptoms, a hormone imbalance, or just need a well woman checkup, our team is here for you. Book an appointment today with our caring, compassionate medical team!


    It is with heavy hearts that we announce that Dr. Sridevi Panchamukhi will be discontinuing her affiliation with HerKare. Dr. Panchamoukhi’s last day with HerKare was Monday, March 27, 2023. As a patient you may obtain copies of your medical records or arrange transfer of your medical records to another physician. HerKare Physician Group, PLLC will continue to maintain your medical records. You may reach out to to obtain copies of your records. We wish Dr. Panchamoukhi the very best.