Estrogen for Treating Depression in Menopausal Women With Hot Flashes and Insomnia

Inclusion Criteria: * Perimenopausal or postmenopausal status * Surgical menopause or hysterectomy with one or both ovaries preserved if serum follicle stimulating hormone is greater than 20 IU/L * Diagnosed with mild to moderate clinical depression * Currently experiencing moderate to severe hot flashes * Currently experiencing insomnia caused by nocturnal hot flashes * Normal mammogram within the 2 years prior to study entry * Willing to use an effective form of contraception throughout the study if perimenopausal and sexually active Exclusion Criteria: * Current severe depression or history of severe depression within the 5 years prior to study entry * Suicidal or homicidal ideation * Psychotic symptoms * History of any psychiatric disorder (e.g., psychosis, bipolar disorder, panic disorder, obsessive-compulsive disorder, or anorexia nervosa) * History of any substance abuse (including alcohol abuse) within the 5 years prior to study entry * Regular use of hormonal medications within the month prior to study entry * Regular use of hypnotic drugs, antidepressants, or over-the-counter drugs known to influence hot flashes, sleep, or mood within the 2 weeks prior to study entry * Intolerance to estrogen therapy or informed that estrogen therapy is medically inadvisable