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Postmenopausal HT may improve mood, does not affect cognition
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Hormone therapy in younger postmenopausal women does not increase the risk for cognitive decline and may lead to beneficial mood effects, according to research in PLOS Medicine.
In a randomized, placebo-controlled trial, researchers also found that menopausal HT had no beneficial effect on clinical depression.
“The cognitive performance of women randomly assigned menopausal HT did not differ from that of women randomly assigned the placebo,” Carey E. Gleason, PhD, of the University of Wisconsin School of Medicine and Public Health, told Endocrine Today. “On a measure of mood states, women treated with conjugated equine estrogens showed improvements compared with those on placebo.”
Carey E. Gleason
Gleason and colleagues analyzed data from 693 recently postmenopausal women in the United States (mean age, 52.6 years; mean of 1.4 years since last menstrual period) participating in the KEEPS-Cog trial. Within the cohort, 220 women were randomly assigned 4 years of 0.45 mg/day oral conjugated equine estrogens plus 200 mg/day micronized progesterone for the first 12 days of each month; 211 women were assigned 50 µg/day transdermal estradiol plus 200 mg/day micronized progesterone for the first 12 days of each month; 262 women were assigned placebo pills and patches.
Researchers assessed cognitive health using the Modified Mini-Mental State Examination, depression symptoms using the Beck Depression Inventory (BDI) and mood using the Profile of Mood States (POMS) instrument at baseline, 18, 36 and 48 months. At baseline, 71 participants reported symptoms of mild or moderately severe depression, although none was diagnosed with clinical depression.
During follow-up, women assigned oral estrogen and progesterone showed improvements in POMS tension–anxiety and depression–dejection scores compared with women assigned placebo. Women assigned transdermal estradiol patches and progesterone, however, did not show improvement on any POMS subscales. In addition, neither hormone formulation affected cognitive function or BDI scores, according to researchers.
“If a woman chooses to manage her menopausal symptoms with HT, she can be reassured that she is not harming her cognition,” Gleason said. “Moreover, she may also experience some mood benefits.”
Researchers noted that the results may not apply to the general postmenopausal population, as most of the women participating in the study were white, well-educated and at low risk for cardiovascular disease.
“It would be beneficial to follow the women in the KEEPS-Cog study beyond 4 years to evaluate the long-term effects of menopausal HT used during the transition period,” Gleason said.
“There is a school of thought that there is a ‘critical window’ for HT, during which HT exposure may be most beneficial for the brain,” she said. “This is supported by basic science data. Follow-up would allow us to test this hypothetical critical window.” – by Regina Schaffer
Disclosure: Gleason reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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