New findings from a study on menopausal women suggest that menopausal hormone therapy may have long-lasting effects on brain structure and cognition. Fortunately, these changes may be positive. The recently published work appears in Neurology®, the medical journal of the American Academy of Neurology.
The researchers recruited 75 healthy women averaging 53 years of age who were between five months to three years past menopause. They were then separated into hormone treatment groups in the form of equine estrogen pills or estradiol skin patches, as well as a placebo control group. In addition, women taking active hormone were also given progesterone pills for the first 12 days each month (and placebos for the control group).
Brain structure and cognitive abilities were measured via MRI scans and memory and thinking tests at various time points: at the start of the study, at 18 months, at three years, and at the end of four years. A subset of women also underwent PET scans to detect plaques in the brain to investigate effects on neurodegeneration.
Results indicated that over the seven years of the study, the group who took estradiol patches maintained brain volume in the dorsolateral prefrontal cortex, an area of the brain that assists with memory, thinking, planning and reasoning. The women who maintained volume in this area of the brain were also more likely to have a lower amount of the amyloid plaque deposits.
"We found that one form of menopausal hormone therapy taken soon after menopause may preserve brain structure in the portion of the brain responsible for memory and thinking skills,” said study first author Kejal Kantarci. "It may also reduce the development of amyloid plaques that can build up and lead to memory loss."
For women who took estrogen pills, the observed structural changes in the brain subsided once the therapy had ended. Thinking and memory test scores were similar for women in the hormone therapy groups when compared to those taking a placebo. The study concluded that estradiol patch treatment results in long-term effects on the brain.
"More research is needed to determine the biological reasons behind brain changes during menopausal hormone therapy. Future research is also needed to better define just how the different hormonal products, pills versus skin patches, affect the brain," says Kantarci.