Beyond SSRIs: Exploring Hormonal Therapy for Mood Disorders in Perimenopause and Postmenopause

Perimenopause and postmenopause are vulnerable periods for the onset or exacerbation of mood disorders due to fluctuating or persistently low estrogen levels and neurochemical changes. While antidepressants are often first-line treatments, a subset of women may benefit from hormone replacement therapy (HRT), particularly transdermal estradiol. This case report presents two women: one, aged 48, experiencing mood instability during perimenopause with pre-existing depression, and another, aged 55, who developed new-onset depressive symptoms during postmenopause. In both cases, treatment with estradiol alongside careful psychotropic management resulted in marked improvement. These cases highlight the utility of an integrative, hormone-informed approach in managing mood disorders during both perimenopause and postmenopause.