Why Transdermal Hormone Therapy May Ease Menopausal Mind

Hormone Replacement Therapy (HRT) via transdermal delivery is found to be highly effective for mental health problems like anxiety and depression in post-menopausal women. Topical administration of estrogen therapy during menopause transition creates different risk profile than oral route, as oral HRT processes through the liver, and has significant impact like cholesterol and other lasting complications of heart, brain, and mental disorders (1^✔ ✔Trusted Source
Oral or Transdermal Hormone Therapy? The Mental Health Risks Are Not the Same

Go to source).

The findings come from a new study presented at the 2025 Annual Meeting of The Menopause Society in Orlando, and published in the journal Menopause. The study underscores that the choice of route in HRT should be individualized based on patient's health.

Patches and Gels Over Pills for Mental Health

A new study involving more than 3,800 postmenopausal women sought to compare the incidence of obesity, cardiovascular disease, anxiety, depression, and Alzheimer’s disease among postmenopausal women receiving oral versus transdermal hormone therapy.

What the researchers found was that transdermal hormone therapy was associated with a lower incidence of anxiety and depression when compared to oral hormone therapy. No significant differences were observed between the two routes of administration in the risk of obesity, cardiovascular disease, or Alzheimer’s disease.

“It was exciting to find statistically significant results in our study, as these findings may help shape more individualized approaches to patient care in the future,” says Liying Wei, lead author from Drexel University College of Medicine.

Excluding Cardiovascular Risk Factors in Hormone Therapy Study

“As we designed this study, we specifically excluded women with established cardiovascular disease (CVD) risk factors such as diabetes, obesity, hyperlipidemia, hypertension, tobacco use, family history of heart disease, and premature menopause to create a CVD risk–free population at baseline.”

“This approach allowed us to more clearly examine the differences between oral and transdermal hormone therapy in relation to CVD outcomes. While our findings suggest that transdermal estrogen may offer potential mental health advantages compared with oral formulations, these results should not be generalized to the broader postmenopausal population.”

“Hormone therapy is not a one-size-fits-all treatment, and the choice of route of administration should be individualized and made through shared decision-making, particularly for women with a history of depression,” says Dr. Xuezhi (Daniel) Jiang, Professor of Obstetrics and Gynecology at Drexel University College of Medicine and Reading Hospital at Tower Health.

Transdermal Hormone Therapy Offers Hope for Mental Health Care

While further studies are needed to confirm these associations, the findings suggest potential mental health advantages of transdermal hormone therapy and underscore the importance of considering the route of administration when prescribing menopausal hormone therapy, especially for women with existing or potential mental health concerns.

“It’s important to recognize the need for individualized approaches when it comes to treating menopause symptoms, says Dr. Stephanie Faubion, medical director for The Menopause Society.

“Fortunately, we have many choices for women when it comes to route of administration, dose, and formulation of hormone therapy, which makes it easier to personalize treatment.”

Reference:

1. Oral or Transdermal Hormone Therapy? The Mental Health Risks Are Not the Same - (https://menopause.org/press-releases/oral-or-transdermal-hormone-therapy-the-mental-health-risks-are-not-the-same)

Source-Eurekalert