Oestrogen and Progesterone

Our rating
 Question mark: This treatment has not been properly researched. It is not possible to say whether they are useful or not.

What is it?

Oestrogen (also called 'estrogen') and progesterone are hormones that are important for sexual and reproductive development in women. Oestrogen and progesterone help to regulate a woman’s menstrual cycle and play an important role in pregnancy. While they are often thought of as ‘female hormones’, oestrogen and progesterone are also found in men.

Oestrogen and progesterone are used in several medical treatments for conditions other than depression. When used as treatments, these hormones are usually taken as a tablet. They can also be given in a skin patch, as a cream or gel, injected or implanted just under the skin, and as a suppository. Oestrogen and progesterone can be given together or separately. They are generally only prescribed to women.

How does it work?

The amount of oestrogen and progesterone in a woman's body varies over her lifetime. Women have lower levels of these hormones in their body at certain times:

  • after childbirth;
  • before, during and after menopause;
  • at certain points in the menstrual cycle, contributing to conditions such as premenstrual syndrome and premenstrual dysphoric disorder.

Depression symptoms can also arise during these times. For example, post-partum depression is a type of depression that occurs after a woman has given birth, and premenstrual syndrome (PMS) can cause symptoms of depression. It is thought that raising the levels of oestrogen and progesterone during these times might improve mood.

Oestrogen supplements may also be able to increase the amount of the chemical messenger serotonin in the brain. Low levels of serotonin are linked to depression.

Is it effective?

Around menopause

There is mixed evidence as to whether oestrogen is effective at reducing depressing around menopause. More studies are needed to confirm the effectiveness of oestrogen in these situations.

Two studies found that oestrogen patches reduced depression symptoms in perimenopausal women (women who were about to go through menopause) who were diagnosed with depression. However, a review of 10 studies found that oestrogen was not clearly linked to a reduction in depression symptoms in women around the time of menopause. In some of these studies, the treatment combined both oestrogen and progesterone. 

There is not much evidence to suggest that oestrogen can be used to treat depression in postmenopausal women (women who have finished going through menopause).

Two studies have looked at the effects of a progesterone skin cream for women who had menopausal symptoms, including depression. The progesterone cream was not more effective than a placebo (dummy) cream in reducing depression symptoms.

After childbirth

There is very little scientific evidence on oestrogen for the treatment of women experiencing postpartum depression (depression which occurs after having a baby). One study found that postpartum women treated with oestrogen had a greater reduction in depression symptoms compared to women treated with a placebo. However, many women who were treated with oestrogen still met the criteria for depression. More studies of better quality are needed to understand the effectiveness of oestrogen in treating depression after childbirth.

Synthetic progesterone is not recommended as a treatment for post-partum depression, and studies have found that it can actually increase the risk of depression during this time.

During the menstrual cycle

Depression can be a symptom of premenstrual syndrome (PMS), which affects some women during their menstrual cycle. Oral contraceptive pills which combine both oestrogen and progesterone have been studied as a treatment for PMS. A pill containing a certain type of progestin (drospirenone) and a low dose of oestrogen has been found to reduce symptoms of PMS better than a placebo (dummy) pill. 

For general depression

There is currently no evidence to suggest that oestrogen or progesterone are helpful for people who have depression which is not linked to natural hormonal changes. 

Are there any disadvantages?

Hormone therapies can cause side effects. For example, common side effects of the oral contraceptive pill include nausea, breast pain and bleeding between periods. Hormone therapy may not be suitable for women who are pregnant or breastfeeding, or who are trying to get pregnant. Any hormone therapies should be taken under the supervision of a health care professional.

Where do you get it?

Most hormone therapies are prescribed by a doctor.

Recommendation

There is some evidence to suggest that oestrogen and progesterone may be helpful for depression symptoms which are linked to hormonal changes in women. However, these treatments are not well researched and are not recommended as a first choice of treatment. More studies of better quality are needed.

There is currently no evidence to suggest that oestrogen or progesterone are helpful for people who have depression which is not linked to natural hormonal changes.

Key references

  • Dennis CL, Ross LE, & Herxheimer A. Oestrogens and progestins for preventing and treating postpartum depression. Cochrane Database Syst Rev. 2008; 4:CD001690. 
  • Grant MD, Marbella A, et. al. Menopausal Symptoms: Comparative Effectiveness of Therapies. 2015; Rockville MD.
  • Lopez, LM, Kaptein A, & Helmerhorst FM Oral contraceptives containing drospirenone for premenstrual syndrome. Cochrane Database Syst Rev. 2008; 1:CD006586.
  • Rubinow DR, Johnson SL, et. al. Efficacy of estradiol in perimenopausal depression: So much promise and so few answers. Depression and Anxiety. 2015; 32(8), 539-549.
  • Whedon JM, KizhakkeVeettil A, Rugo NA, & Kieffer KA. Bioidentical estrogen for menopausal depressive symptoms: a systematic review and meta-analysis. Journal of Women's Health. 2017; 26(1), 18-28.

Last reviewed and updated: 1 May 2019