The study has shown that long-term and consistent use of hormone replacement therapy (HRT) can help improve certain cognitive areas, particularly non-verbal or spatial memory and attention.

Now, U-M physicians will continue to study the effects of HRT on the brain and offer more women information to help them make the difficult decision of whether or not to use HRT.

Because estrogen receptors are located throughout the brain, the hormone can affect the brain's functions in multiple ways, one of which is memory.

According to Yolanda R. Smith, M.D., assistant professor and research investigator in the U-M Division of Reproductive Endocrinology, other studies also have suggested that estrogen does affect memory, especially in post-menopausal women. Most of these studies, however, have been based on short-term use of estrogen replacement and measured a woman's memory during treatment.

"When women go through peri-menopause, estrogen levels will vary in their brain and then eventually become much lower than what they were during the reproductive years, " she says. "The lower levels affect different neurotransmitter systems in the brain and they can potentially affect cognition and mood."

Unlike other studies of its kind, the U-M study focused on the affects of long-term estrogen replacement therapy. It looked at women, all 60 years of age or older, who had been using estrogen since menopause. This group was then compared to another group of women who had never used estrogen anytime during or after menopause.

The women in the study were tested with a comprehensive neuropsychological testing battery, which measured different memory functions including verbal and non-verbal memory. The researchers also examined the women's attention and concentration during the tests. The study revealed that women who had been on estrogen since the time of menopause (long-term users) had improved scores in non-verbal memory (spatial memory) and attention when compared to the women who had never taken estrogen.

In spite of the study's results, Smith says that taking estrogen during menopause is a very individual decision that women need to make with their physicians.

"It's important for women to review their concerns and what their risk factors are for heart disease, breast cancer and osteoporosis before taking estrogen," she says. "Estrogen replacement may be something that can help temporize some of the mild symptoms that occur during menopause, too, and is something to consider for long-term use."

In addition to memory, HRT may also help prevent and treat bone loss caused by osteoporosis, which increases the risk of bone fractures. HRT also treats symptoms of low estrogen, including hot flashes and vaginal dryness.

A U-M study focusing again on long-term estrogen use is already in the works. It will further compare long-term estrogen users to non-estrogen users to investigate their cognitive function.

The study will also look at the brain areas used when women are performing certain cognitive tests and will image different neurotransmitter systems in the brain.

(Editor's Note: The study is presently recruiting participants. For more information on the study call 734-647-7266.)

21-May-2002