Irritability and Hormone Replacement Therapy in Women Attending a Menopause Clinic: A Cross-Sectional Study

Background: The menopausal transition is frequently associated with affective symptoms, including irritability, which remains relatively understudied despite its clinical relevance. Hormone replacement therapy (HRT) may influence affective symptoms through hormonal and metabolic mechanisms, including modulation of oxidative stress. However, the relationship between HRT and irritability in menopausal women remains poorly understood. Methods: We conducted a cross-sectional study of 84 women attending a menopause clinic between 2020 and 2025. Irritability was assessed using the single irritability item of the Greene Climacteric Scale. Associations between HRT use and irritability were explored using descriptive statistics, multivariable logistic regression, and exploratory predictive modelling controlling for age and clinical variables. Results: Approximately 27% of participants were receiving HRT. Descriptive analyses suggested higher HRT use among women reporting irritability compared with those without irritability. However, multivariable models did not confirm a statistically significant association between irritability and HRT use (OR = 1.66, p = 0.244). Age was the only variable significantly associated with HRT use (OR = 0.89, p = 0.009). Exploratory differences in psychopharmacological prescribing patterns did not reach statistical significance. Conclusions: In this clinical sample, irritability was a common symptom during the menopausal transition but was not significantly associated with HRT use. The medication-class findings were exploratory and did not establish an association with irritability. Larger longitudinal studies are needed to clarify the relationship between hormonal treatments and affective symptoms in menopause.