Hormone therapy and phytoestrogens alleviate psychological symptoms in menopausal women, particularly mood and anxiety.
This systematic review and meta-analysis of 51 RCTs (n=41,821) for hormone therapy and 16 RCTs (n=1,191) for phytoestrogens found that both interventions reduced psychological symptoms in menopausal women, especially mood and anxiety. Tibolone showed a significant improvement in depression (SMD 0.93, 95% CI 0.62-1.24). Post-menopausal women experienced greater benefits for sleep quality with hormone therapy and for depression and anxiety with phytoestrogens compared to perimenopausal women.
Evidence Score
Study Evidence
Study 1. Efficacy of hormone therapy and phytoestrogens on the psychological symptoms of menopausal women: a systematic review, meta-analysis, and trial sequential analysis.
metaShou M, Ye M, Lou C, Chen X, Yao Y, Yan J, Zhou W, Fu Z, Liu Z · Frontiers in medicine (2026)
Result: This systematic review and meta-analysis of 51 RCTs (n=41,821) for hormone therapy and 16 RCTs (n=1,191) for phytoestrogens found that both interventions reduced psychological symptoms in menopausal women, especially mood and anxiety. Tibolone showed a significant improvement in depression (SMD 0.93, 95% CI 0.62-1.24). Post-menopausal women experienced greater benefits for sleep quality with hormone therapy and for depression and anxiety with phytoestrogens compared to perimenopausal women.
Mechanism Graph
Limitations
- ⚠Some significant outcomes failed correction in trial sequential analysis and require further validation
- ⚠Effects differed by symptom type and menopausal stage, limiting generalizability across all subgroups
Frequently Asked Questions
What psychological symptoms were improved by hormone therapy and phytoestrogens?▼
The study found improvements in mood, anxiety, depression, and sleep quality, with post-menopausal women showing greater benefits for sleep quality with hormone therapy and for depression and anxiety with phytoestrogens.
How large was the effect of Tibolone on depression?▼
Tibolone showed a significant improvement in depression with a standardized mean difference (SMD) of 0.93 and a 95% confidence interval of 0.62 to 1.24.
Were the findings statistically robust?▼
Trial sequential analysis confirmed the robustness of most findings, but some significant outcomes failed correction and require further validation.
Did the effects differ between perimenopausal and post-menopausal women?▼
Yes, post-menopausal women showed a greater beneficial effect of hormone therapy on sleep quality and of phytoestrogens on depression and anxiety compared to perimenopausal women.
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References
- 1.Shou M, Ye M, Lou C, Chen X, Yao Y, Yan J, Zhou W, Fu Z, Liu Z. "Efficacy of hormone therapy and phytoestrogens on the psychological symptoms of menopausal women: a systematic review, meta-analysis, and trial sequential analysis.." Frontiers in medicine, 2026. PMID: 42500528 DOI: 10.3389/fmed.2026.1855845