Menopause & Hormone Health
If Your GP Gave You
Antidepressants For
Menopause, Read This
Low mood, anxiety, and emotional changes during menopause aren't a mental health problem. They're a hormone problem. And there's a crucial difference in how they should be treated.
What's Going On
Too Many Women Are Being Given the Wrong Treatment
Imagine going to your GP feeling exhausted, anxious, tearful, unable to sleep, and not quite yourself — and leaving with a prescription for antidepressants. No mention of hormones. No conversation about perimenopause. Just a box of SSRIs and a follow-up appointment in six weeks.
For millions of women in the UK, that's not a hypothetical — it's exactly what happened. A Newson Health survey of nearly 6,000 women found that 39% were offered antidepressants instead of HRT as their first course of treatment when they sought help for perimenopausal or menopausal symptoms. Fewer than 3% of women in that age group were actually prescribed HRT.
This matters enormously — because antidepressants don't treat the root cause of menopausal mood symptoms. They can't. The low mood, anxiety, and emotional changes of perimenopause aren't caused by a serotonin deficiency. They're caused by declining oestrogen. And no amount of SSRIs will fix a hormone problem.
Antidepressants are not effective for the low mood and anxiety associated with perimenopause — because they don't address the underlying cause: low hormone levels.
Why It Happens
It's Not Your GP's Fault — But It Is a System Problem
Most GPs receive very little training in menopause medicine. A 2023 survey of medical residency programmes found that menopause education is significantly lacking in standard training. The result is that many doctors simply aren't equipped to recognise perimenopausal symptoms — especially the psychological ones — for what they are.
The symptoms of perimenopause and depression also genuinely overlap. Low mood, poor sleep, fatigue, loss of motivation, anxiety — these tick the boxes for depression on standard screening tools. Without understanding the hormonal context, it's easy to reach for the prescription pad.
There's also a legacy effect from the early 2000s, when a flawed study caused HRT prescriptions to plummet. In their place came a surge in antidepressants, sleep aids, and anti-anxiety medication for menopausal women. That pattern persisted in many GP surgeries long after the science had moved on.
The good news? Updated NICE guidelines published in November 2024 are clear: HRT should be offered as the first-line treatment for menopausal symptoms, including psychological ones. The evidence is on your side — even if your GP hasn't caught up yet.
The Symptoms Nobody Warned You About
Menopause Is So Much More Than Hot Flushes
Most women know about hot flushes and night sweats. Far fewer are warned about the psychological symptoms — which for many women are actually the first and most distressing signs of perimenopause.
Psychological symptoms (most commonly misdiagnosed)
Physical symptoms
How common are psychological symptoms in perimenopause?
From a Newson Health survey of 5,744 women:
Source: Newson Health survey, 5,744 women. These symptoms are hormonal — not psychiatric.
HRT vs Antidepressants
Why HRT Is the Right First Conversation — Not the Last Resort
Hormone replacement therapy replaces the oestrogen (and sometimes progesterone and testosterone) that your body is no longer producing in the same quantities. When mood symptoms are caused by declining oestrogen — which they are during perimenopause — addressing that hormonal shift treats the actual cause.
Antidepressants work on serotonin and norepinephrine pathways. They can be genuinely helpful for clinical depression and anxiety disorders. But when the root cause is hormonal, they're addressing the wrong system — and for most women, the results reflect that.
HRT vs antidepressants — what the evidence shows for menopausal mood symptoms
Based on NICE 2024 guidelines and peer-reviewed menopause research. SSRIs may help some women, particularly those who cannot take HRT — but are not first-line for hormonally driven symptoms.
A 2024 study found that just three months of hormone therapy significantly improved depressive symptoms in perimenopausal women. Many women who begin HRT and had previously been prescribed antidepressants find their mood improves so substantially that they can gradually come off antidepressants altogether — with medical supervision.
A Real Story
You Are Not Imagining It
Sam's story — treatment-resistant depression or unrecognised perimenopause?
"I have gradually felt better. I no longer burst into tears. My energy, motivation and capacity for joy is returning. I feel more sociable and I enjoy rather than fear social events. During the last 12 months, I've gradually reduced and stopped taking antidepressants and anti-anxiety medications. I have found HRT to be more effective at treating my mental illness symptoms than any of the psychiatric medications I've been prescribed — with none of the side effects and lots of long-term health benefits."
Sam had been diagnosed with treatment-resistant depression for years. She was prescribed multiple antidepressants, anti-anxiety medications, and even ketamine infusions. At 45, she started HRT. This story is not unusual — it's one of thousands. The tragedy is how long it takes many women to get there.
What HRT Actually Does
The Benefits Go Far Beyond Mood
HRT isn't just about managing symptoms. It's also about long-term health protection. Oestrogen plays a critical role in bone density, cardiovascular health, brain function, and metabolic health. Declining oestrogen during menopause increases risk across all of these areas — and HRT helps maintain those protective effects.
What to Do Next
You Have the Right to Ask for Better
Updated NICE guidelines are clear: if you're experiencing menopausal symptoms, HRT should be the first conversation — not a last resort. If you've been offered antidepressants and haven't had a proper discussion about hormones, you are absolutely within your rights to ask for one.
Track your symptoms
Use an app like Balance (Dr Louise Newson's menopause tracker) to log your symptoms before your GP appointment. This gives you a clear picture to present and helps frame the conversation around hormones — not just mood.
Ask specifically about HRT
Don't wait for your GP to raise it. Say: "I've been reading about perimenopause and I'd like to discuss whether HRT might be appropriate for me." The new NICE guidelines support this conversation.
Get your hormones tested
A hormone blood test — including oestradiol, FSH, LH, and testosterone — gives you a clearer picture of where your levels are. Private testing means you don't have to wait and don't have to fight for it.
Seek a second opinion if needed
If your GP isn't engaging with your concerns, seek a menopause specialist — either through the NHS (ask for a referral) or via a private menopause clinic. You deserve a doctor who understands what you're going through.
Don't stop antidepressants abruptly
If you're already on antidepressants and want to transition to HRT, always do this with medical supervision. Coming off antidepressants requires a gradual taper — never stop suddenly.
If you're told to "just get on with it" or offered only antidepressants without discussion of HRT — seek a second opinion. The updated guidelines are clear: individualised care is essential.
Know Your Hormones. Know Your Options.
At Boost & Glow, we believe every woman deserves access to the right information — and the right treatment. Whether you're looking to get your hormones tested privately or simply want to understand your options better, we're here to help.
Explore Boost & Glow → Ask Us a Question →This blog is for informational purposes only and does not constitute medical advice. It is not intended to discourage the use of antidepressants, which are an important and effective treatment for clinical depression and anxiety disorders. If you are currently taking antidepressants, do not stop taking them without speaking to your doctor first. Always seek personalised medical advice from a qualified healthcare professional regarding your symptoms and treatment options.
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