Differential effects of estrogen and micronized progesterone or
medroxyprogesterone acetate on cognition in postmenopausal women.
Author(s): Sherwin BB, Grigorova M.
Affiliation(s): Department of Psychology, McGill University, Montreal, Quebec, Canada.
barbara.sherwin@mcgill.ca
Publication date & source: 2011, Fertil Steril. , 96(2):399-403
OBJECTIVE: To investigate possible differential effects of the coadministration
of conjugated equine estrogen (CEE) and a placebo (CEE + PL), CEE and
medroxyprogesterone acetate (CEE + MPA), or CEE and micronized P (CEE + MP) on
aspects of cognitive functioning in naturally postmenopausal women.
DESIGN: Double-blind, randomized, controlled trial.
SETTING: Gynecologic screening occurred at a university hospital, and
neuropsychological testing took place in a university laboratory.
PATIENT(S): Twenty-four naturally menopausal women with an intact uterus who had
never used hormone therapy were recruited by means of newspaper advertisements.
All completed the study.
INTERVENTION(S): A battery of mood and neuropsychological tests was administered.
Women were randomly assigned to receive CEE + PL (n = 7), CEE + MPA (n = 9), or
CEE + MP (n = 8). The tests were readministered 12 weeks later.
MAIN OUTCOME MEASURE(S): Standardized tests of mood, verbal memory, working
memory, spatial abilities, and visual-spatial sequencing, and assays of serum sex
hormone levels.
RESULT(S): Mood improved after treatment in all groups. No changes in scores
occurred over time in any cognitive test in the group that received CEE + PL.
Only the CEE + MP group had a significant decrease in their delayed verbal memory
scores from baseline to after treatment. The CEE + MP-treated women performed
significantly better on a test of working memory than women in the other two
groups.
CONCLUSION(S): Coadministration of CEE with MPA or MP caused differential effects
on aspects of memory in postmenopausal women. These findings need to be
replicated with a larger sample size before their potential clinical implications
can be determined.
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