Psychol Med

Hormone therapy during menopause may not relieve mood or sleep symptoms

January 27, 2026

In an analysis of ~125,000 women from the UK Biobank, postmenopausal status was associated with higher anxiety and depressive symptoms, greater insomnia, and shorter sleep duration compared with premenopause (all p<0.0001). Women using hormone replacement therapy (HRT) reported significantly higher depression and anxiety scores than postmenopausal nonusers, largely reflecting greater pre-existing symptoms. Cognitive performance showed minimal differences, with no consistent memory benefit from HRT. Neuroimaging in >10,000 participants showed smaller hippocampal and anterior cingulate gray matter volumes after menopause, lowest in HRT users (p<0.0001).

Clinical takeaway: Routinely screen menopausal patients for mood and sleep disorders, and counsel that HRT may relieve somatic symptoms but should not be expected to reliably improve cognition or mental health.

Source:

Zühlsdorff, K et al. (2026, January 27). Psychol Med. Emotional and cognitive effects of menopause and hormone replacement therapy. https://pubmed.ncbi.nlm.nih.gov/41587742/