Maintaining Memory with Hormones

September 4, 2018

 

Menopausal women with baseline memory impairment who used hormone therapy during a recent 2 year study saw no decline in memory, while users of placebo did have worsening cognition.  The title of the study was, “Menopausal hormone therapy and mild cognitive impairment: a randomized, placebo-controlled trial.”

 

https://journals.lww.com/menopausejournal/Abstract/2018/08000/

 

The subject of memory loss is an important one to most of us.  The Women’s Health Initiative (WHI) data did not support an improvement in memory with menopausal hormone therapy, however (and this is a big however), we have to remember the WHI used suboptimal hormones - conjugated equine estrogen (Premarin) and medroxyprogesterone (Provera, a synthetic progestin).  The study I’m discussing today used the 2 forms of hormone therapy that I prefer, estradiol gel and oral micronized progesterone.

 

I prefer the topical formulations of estrogen because of the evidence supporting a decreased risk of clotting with this route of delivery (vs oral estradiol pills).  

 

I prefer micronized progesterone because this is a natural form of progesterone which has beneficial effects on anxiety and sleep. 

 

The strength of this study was that it was a randomized, placebo-controlled trial using the best and safest forms of hormone therapy available.  The weakness is that it was small, only 37 patients.  

 

What’s exciting is that the results of this study will hopefully spark more interest and prompt researchers to embark on a larger scale study that will shed more light on the potential neurologic benefits of hormone therapy.   

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