Hum Reprod Update. 2009 May 25.
Hormone therapy and cognitive function.
Maki PM, Sundermann E.
Neuropsychiatric Institute, MC 913, University of Illinois at Chicago, 912 South
Wood Street, Chicago, IL 60612, USA.
BACKGROUND Clinical trials yield discrepant information about the impact of
hormone therapy on verbal memory and executive function. This issue is
clinically relevant because declines in verbal memory are the earliest predictor
of Alzheimer's disease and declines in executive function are central to some
theories of normal, age-related changes in cognition. METHODS We conducted a
systematic review of randomized clinical trials of hormone therapy (i.e. oral,
transdermal, i.m.) and verbal memory, distinguishing studies in younger (i.e.
</=65 years of age; n = 9) versus older (i.e. >65 years; n = 7) women and
studies involving estrogen alone versus estrogen plus progestogen. Out of 32
placebo-controlled trials, 17 were included (13 had no verbal memory measures
and 2 involved cholinergic manipulations). We also provide a narrative review of
25 studies of executive function (two trials), since there are insufficient
clinical trial data for systematic review. RESULTS There is some evidence for a
beneficial effect of estrogen alone on verbal memory in younger naturally
post-menopausal women and more consistent evidence from small-n studies of
surgically post-menopausal women. There is stronger evidence of a detrimental
effect of conjugated equine estrogen plus medroxyprogesterone acetate on verbal
memory in younger and older post-menopausal women. Observational studies and
pharmacological models of menopause provide initial evidence of improvements in
executive function with hormone therapy. CONCLUSIONS Future studies should
include measures of executive function and should address pressing clinical
questions; including what formulation of combination hormone therapy is
cognitively neutral/beneficial, yet effective in treating hot flashes in the
early post-menopause.
Please click on the required question.
- 1 HRT help me with the psychological difficulties that I am experiencing around?
- 2 HRT help my mental ability?
- 3 Can HRT reduce my chance of developing heart disease?
- 4 How does HRT protect against coronary heart disease?
- 5 If I am at particular risk of heart disease, can HRT still help?
- 6 Do progestogens taken in combination with oestrogen replacement therapy have an adverse effect on heart protection?
- 7 How long should HRT be taken to reduce the risk of heart disease?
- 8 Is there any evidence that HRT will protect my bones?
- 9 Would the dose (strength) of my HRT influence its ability to protect my bones?
- 10 Are there other treatments apart from HRT for osteoporosis?
- 11 Would HRT help my skin?
- 12 Can hormone replacement therapy cure all my menopausal symptoms?
- 13 How prevalent is cancer of the breast?
- 14 What factors influence the chance of breast cancer developing?
- 15 What is the relationship between HRT and breast cancer?
- 16 I have benign breast disease. Can I take HRT?
- 17 Does a history of breast cancer mean that HRT is absolutely contraindicated?
- 18 If I started HRT early (aged 30 to 45), does this influence my chance of developing breast cancer?
- 19 Does hormone replacement therapy increase the risks of cancer of the womb?
- 20 I have had endometrial cancer and now have menopausal problems. Can I take HRT?
- 21 Does HRT have a relationship to ovarian cancer?
- 22 How does HRT relate to a blood clot (DVT - deep venous thrombosis or pulmonary embolism)?
- 23 I have varicose veins. Can I take HRT?
- 24 Should HRT be discontinued before I have a major operation or leg surgery?
- 25 Does HRT increase life-expectancy?
- 26 I am still seeing periods. Could HRT have any benefits for me?
- 27 I have been told that I have fibroids. Can I take HRT?
- 28 What happens if I decide not to take HRT?
- 29 Doctors seem to promote HRT but the media cause me anxiety. Who is right?
- 30 Support Groups.
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