Depression during the perimenopausal transition is a significant concern for women’s
mental health and quality of life. Hormone Replacement Therapy (HRT), traditionally used to
manage vasomotor and genitourinary symptoms of menopause, has also been investigated for its
potential to alleviate depressive symptoms associated with hormonal fluctuations. This
integrative literature review examined the impact of HRT on depression in perimenopausal
women by analyzing articles published between 2014 and 2025, reflecting the most recent
evidence following shifts in clinical practice post-Women’s Health Initiative. A comprehensive
search strategy using Medline (Ovid), CINAHL (EBSCO), PsycINFO (EBSCO), and Google
Scholar was employed, utilizing Medical Subject Headings (MeSH) and keywords. Six primary
studies met inclusion criteria and were critically appraised and synthesized. Key themes arising
out of the studies were the timing of HRT initiation, individual variability in depressive symptom
response, and methodological heterogeneity across studies. Findings suggest that HRT,
particularly transdermal estradiol, may be effective in reducing depressive symptoms when
initiated during early perimenopause. However, inconsistencies in study design, outcome
measures, and population definitions highlight the need for more standardized, high-quality
research. These findings have implications for nurse practitioners and other primary care
providers who play a critical role in screening, education, and patient-centered decision-making
in the management of menopausal mental health.
