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SSRI's Have Side Effects, but is Hormone Replacement the Answer?

April 04, 2012 10:03 AM | Christiaan Killian (Administrator)

Can hormone replacement therapy replace antidepressants? Antidepressant medication, also known as selective serotonin reuptake inhibitors (SSRIs), has been shown to have a number of side effects, including insomnia, nervousness, sleep problems, headaches, joint and muscle pain, stomach upset, sexual dysfunction, and bleeding problems. Even so, antidepressants are the third most widely prescribed group of medications in the United States. Many individuals may be taking antidepressants for minor complaints, without considering the potential risks. What some may not realize is that hormone replacement therapy may be considered a safer, effective alternative to SSRIs.

Hormone imbalances can lead to depression.

In men, low testosterone levels can cause mood and emotional issues. If male patients choose to take SSRIs to treat depression, they increase their risk of infertility and sperm quality damage. SSRIs have been shown to reduce sperm count in men by 50 percent, as well as damage the motility and shape of the sperm.1 2

In contrast, hormone replacement therapy (HRT) restores the body’s natural production of hormones, including testosterone, to relieve depression and emotional issues that are related to hormone imbalances. Men that are concerned about the side effects associated with antidepressant medications may find HRT to be a safe and effective alternative.

Research has suggested that HRT and antidepressant therapy may have similar molecular targets.

When the results of the Women’s Health Initiative were published, many women immediately stopped HRT; a subsequent increase in the use of antidepressants is well documented. Women who were using HRT had climacteric symptoms reduced, including depression. 3 Estrogen therapy has been suggested to effectively treat perimenopause women with depressive disorders.4 5

HRT goes beyond just relieving depression to provide overall health benefits on cognitive function, cardiovascular health, weight management, energy, sexual health, and quality of life that result in confidence and a better mood. Even so, does this make hormone replacement the answer for treating depression? If a patient’s depression is related to hormone imbalances, then HRT can dramatically improve mood without the side effect of common antidepressants and anti-anxiety medications. Yet, HRT may not be the answer for everyone.

Start by reviewing the Big Picture

Overall, it is best to determine the method of treatment on an individual basis. Start by reviewing the big picture, which includes nutrition, exercise, and lifestyle habits.

Dr. Louis Cady, known for studying the connection between psychiatry, hormones, and wellness, explains, “In many cases I found that I could not make them better working from the neck up, and that no matter how good my potions were they didn’t get better. And then I began looking a little bit further. I got more professional education and began to understand this mind-body divide in contemporary medicine. Where if a conventionally trained physician can’t diagnose somebody in terms of really what is going on, they will say, “Well, it is all in your head” and then I will get them. And I will find many times that it is not just in their head. It may be in their thyroid or it may be in other parts of their body. They may have a sleep disorder. And so I decided that instead of just limiting myself to pushing pills all day I was going to do what I was trained to do, which was to be a complete physician.”

Establish the basics.

The best solutions to consider for depression or any other health complaints are proper nutrition, exercise, behavior modification, and natural hormone balancing. All of these are crucial elements to increase well-being, vitality, and health. While SSRI's still serve a necessary purpose for many people, instead of first looking at an antidote to fix the problem, it is best to look at what is needed to maximize the patient’s overall health and happiness.


    1. Hendrick V, Gitlin M, Altshuler L, Korenman S. Antidepressant medications, mood and male fertility. Psychoneuroendocrin. 2000 Jan;25(1):37-51.
  1. Tanrikut C, Feldman AS, Altemus M, Paduch DA, Schlegel PN. Adverse effect of paroxetine on sperm. Fertil Steril. 2010 Aug;94(3):1021-1026.
  2. McIntyre RS, Konarski JZ, Grigoriadis S, Fan NC, et al. Hormone replacement therapy and antidepressant prescription patterns: a reciprocal relationship. CMAJ. 2005 Jan;172(1):57-59.
  3. De Novaes Soares C, Almeida OP, Joffe H, et al. Efficacy of estradiol for the treatment of depressive disorders in perimenopausal women: a double blind, randomized, placebo-controlled trial. Arch Gen Psychiatry. 2001 Jun;58(6):529-534.
  4. Schmidt PJ, Nierman L, Danaceau MA, et al. Estrogen replacement in perimenopausal-related depression: a preliminary report. Am J Obstet Gynecol. 2000;183:414-¬420.

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