Women’s emotional symptoms as they approach menopause vary. Some may experience no symptoms at all while others may have mood swings, depression, anxiety, panic attacks, anger, short temper, snappiness, crying episodes, and irritation. These symptoms can be debilitating and may significantly impair one’s quality of life. In addition, menopausal women suffering from low mood and decreased energy levels may increase their risk of developing mood disorders. Thus, ERT has been proposed as a potentially effective therapeutic strategy for mood disorders experienced during menopause. A number of high quality studies support the mood-enhancing effects of ERT:
1. In perimenopausal women with DSM-IV-defined major depressive disorder who have minimal response to antidepressants, ERT significantly improves depressive symptoms and scores in the Hamilton Rating Scale for Depression (HAM-D). 
2. In younger mid-life women, 3 months of ERT is associated with significant improvements in mood, everyday memory, working memory, and delayed verbal memory. 
3. In women with postpartum depression, transdermal and sublingual estradiol therapy appears to be safe and effective in alleviating depressive symptoms. [173-174]
4. In perimenopausal and postmenopausal women, ERT reduces both physical and depressive symptoms while increasing energy levels. [175-187]
5. In depressed perimenopausal women, estrogen favorably influences neurotransmitters (brain chemicals) involved in mood regulation. [188-190]
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