Doctors may someday be able to predict which women with depression, hot flashes, and other symptoms of menopause will be helped by short-term estrogen therapy, preliminary research shows.
The study shows that women who are cured of their depression exhibit a distinctive pattern of electrical activity in the brain, with changes in the region involved in emotions and judgment, says researcher Ian A. Cook, MD, associate professor of psychiatry at the University of California, Los Angeles.
"This could be a test that could tell us which women would benefit from short-term estrogen in terms of depression and maybe other symptoms," he tells WebMD.
Cook presented the study at the annual meeting of the American Psychiatric Association.
The study included 13 women aged 40 to 60 with both depression and classic symptoms of menopause, such as hot flashes and night sweats.
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"All the women were on antidepressants, but none were fully responding," Cook says.
Since out-of-whack hormone levels are often blamed for the symptoms of menopause, "we wanted to see if low-dose estrogen would help," he says. It did, but only in some cases, Cook tells WebMD.
What's more important, Cook says, is that the women's electrical brain activity, as measured by electroencephalography, or EEG, pinpointed which women responded.
Brain electrical activity was measured at the start of the study and six weeks after treatment with 0.625 milligrams of estrogen daily.
Women who experienced remission of depressive symptoms had significant changes in areas of the brain associated with emotion and judgment.
There was no significant change in women who did not remit.
Click here to read WebMD's "Menopause Is an Emotional Roller Coaster"
Estrogen Soothes Unpredictable Fluctuations in Hormones
Hadine Joffe, MD, director of endocrine studies in the perinatal and reproductive psychiatry clinical research program at Harvard Medical School, says the study offers further evidence that short-term estrogen can help smooth out the unpredictable, erratic fluctuations of hormone levels in the brain during menopause.
Ever since the Women's Health Initiative study showed that postmenopausal women given estrogen plus a progestin had an increased risk of breast cancer, doctors have been recommending that women suffering from menopause symptoms take the lowest dose of estrogen for the shortest amount of time.
A test like this could narrow the playing field even further, the experts say.
"It's a small, preliminary study, but by measuring brain activity they could see who improved," Joffe tells WebMD. "Further study is warranted."
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SOURCES: American Psychiatric Association 2005 Annual Meeting, Atlanta, May 21-26, 2005. Ian A. Cook, MD, associate professor of psychiatry, University of California, Los Angeles. Hadine Joffe, MD, director, endocrine studies, perinatal, and reproductive psychiatry clinical research program, Harvard Medical School, Boston.