HRT linked to reduced psychosis relapse risk in menopausal women

New study highlights potential benefits of menopausal hormone therapy

A recent study published in the American Journal of Psychiatry suggests that menopausal hormone therapy (HRT) may reduce the risk of psychosis relapse in menopausal women.

The research, led by Bodyl Brand from the University of Oxford, in collaboration with experts from universities in the Netherlands, Finland, and Sweden, supports the protective effects of oestrogen on the brain.

The study analysed medical records of 3,488 Finnish women diagnosed with schizophrenia or schizoaffective disorder (SSD). Researchers compared hospitalisation rates for psychosis during periods when the women were using HRT to periods when they were not.

The findings revealed that HRT use was associated with a 16% lower risk of psychosis relapse in women aged 40-62.

“We found that the use of menopausal hormone therapy was associated with a lower relapse risk for psychosis as compared to non-use and was specifically effective in preventing relapse when started before the age of 56,” said Brand.

Existing evidence indicates that women with SSD experience worsening outcomes as they age, particularly after 45, with increased relapse rates and reduced effectiveness of antipsychotic medications.

Brand emphasised, “Women with schizophrenia or schizoaffective disorder of menopausal age form an exceptional group which is susceptible to psychosis relapse, but also to side effects of antipsychotic medication. Therefore, it is important to ensure there are appropriate systems, services and support in place to support women in the event of relapse. But, given its potential and safety, continued efforts are also needed to make menopausal hormone therapy more accessible and acceptable in this vulnerable group of women.”

Oestrogen, known for its antioxidant properties, helps the brain adapt and function effectively. Its levels naturally decline during the perimenopause, highlighting the potential benefits of HRT in mitigating psychosis relapse risks.