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Review on November 19, 2009
 As a result of tumultuous perimenopause symptoms and their ability to upset the routine of daily life, may women turn to hormone replacement therapy. The added hormones in this therapy, including estrogen and sometimes progesterone are responsible for the relief and prevention of many perimenopause symptoms. Unfortunately they are also responsible for other side effects, sometimes even fatal ones. Many studies are ongoing to determine just how much hormone therapy helps and harms its users. One recent hypothesis was made to determine if menopausal estrogen and progesterone use affected the cognitive abilities of users. This study was conducted to determine the results.
The connection between estrogen and cognition (awareness, perception, reasoning and judgment) is both controversial and uncertain. To get a better grasp of the association linking estrogen and cognition, an observational study was conducted on 837 Japanese American women. All participants were 65 years or older and lived in Washington state. The women were determined at baseline for cognitive performance by examinations using the Cognitive Abilities Screening Instrument (CASI). A two-year follow up was also conducted.
Almost half (455) of the participants incorporated in this observational study had never used estrogen or progesterone hormones to relieve perimenopause symptoms at any time since menopause. 186 women taken estrogen previously, 132 women were current estrogen users and 64 women were presently/currently taking estrogen - progestin combination therapy.
 Modifications were made for age, education level, language spoken at the interview for this study, type of menopause (natural or surgical) and the baseline CASI score. The conclusions found that women who had never used estrogen for post menopause symptoms had improved slightly on the CASI scale. The change was greater for present estrogen users and worse for current estrogen - progestin combination users in comparison with the women who never used estrogen.
The ultimate conclusion supports that there is a modest beneficial connection with current estrogen use and the rate of cognitive change in women that were looking for relief from perimenopause symptoms. A negative connection was also observed between estrogen - progestin combination use and the rate of cognitive change.
This survey also showed that progesterone hormones had the opposite effect of estrogen hormones. As estrogen has a suspected beneficial influence on cognitive performance, progesterone hormones may actually have a negative influence on brain structure and function.
This study shows both the positive and negative effects experienced by women who use hormone therapy for relief from perimenopause symptoms. Estrogen alone, without progestin, improves cognitive function in post menopausal women. As with all studies, in order to prove the information worthy of a clinical setting, more data from larger and long term trials are required.
- SOURCES:
JAMA - The Journal of the American Medical Association
JAMA. 2003;289:2663-2672.
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