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The effect of short-term estradiol therapy on cognitive function in older men receiving hormonal suppression therapy
Pamela Taxel1, Michael C Stevens, Margaret Trahiotis
1Division of Endocrinology and Metabolism and Center on Aging, University of Connecticut Health Center, Farmington, Connecticut 06030, USA. taxel@nso.uchc.edu
Objectives:
To determine the effect of estrogen (E) alone (without the influence of testosterone (T)) on cognitive function in older men, using 17-beta micronized estradiol versus placebo in older men rendered hypogonadal (low T and E) by treatment for prostate cancer.
Design:
Short-term double-blind, randomized, controlled trial.
Setting:
An outpatient General Clinical Research Center.
Participants:
Twenty-seven community-dwelling men aged 65 and older receiving neoadjuvant or established therapy with luteinizing-hormone releasing-hormone agonists for treatment of prostate cancer enrolled in a short-term randomized, controlled trial of 17-beta micronized estradiol versus placebo on the effect on biochemical markers of bone turnover.
Measurements:
Hormone levels, including E, T, and sex hormone-binding globulin; standardized neurocognitive tests, including measures of sustained attention, executive function, and memory; and questionnaires to assess subjects' perception of cognitive deficits and symptoms of depression.
Results:
There were no significant differences between patients receiving E or placebo on 15 of 17 neurocognitive measures and no significant differences in self-reported cognitive deficits or number of depressive symptoms.
Conclusion:
Although studies have suggested that E replacement therapy may improve cognitive function, most notably memory performance in postmenopausal woman, there was no evidence in the present study that the addition of short-term E therapy was more beneficial than placebo in tests of cognitive performance in hypogonadal men.
Insights
Estrogen therapy did not improve cognitive function in older men with low testosterone and estrogen due to prostate cancer treatment. Short-term estrogen replacement showed no cognitive benefits compared to placebo in this hypogonadal male population.
Area of Science:
- Endocrinology
- Neuroscience
- Gerontology
Background:
- Estrogen's role in cognitive function is established in postmenopausal women.
- The impact of estrogen alone on cognition in hypogonadal older men is less understood.
- Prostate cancer treatments often induce hypogonadism, affecting hormone levels in older men.
Purpose of the Study:
- To investigate the effect of estrogen (E) monotherapy on cognitive function in older men with low testosterone and estrogen.
- To assess if 17-beta micronized estradiol improves cognition in hypogonadal men undergoing prostate cancer treatment.
Main Methods:
- A short-term, double-blind, randomized, placebo-controlled trial was conducted.
- Twenty-seven men aged 65+ with prostate cancer-induced hypogonadism received either 17-beta micronized estradiol or placebo.
- Cognitive performance was evaluated using standardized neurocognitive tests, alongside hormone level measurements and symptom questionnaires.
Main Results:
- No significant differences in cognitive performance were observed between the estrogen and placebo groups for 15 out of 17 neurocognitive measures.
- Self-reported cognitive deficits and depressive symptoms did not differ significantly between the two groups.
Conclusions:
- Short-term estrogen therapy did not demonstrate cognitive benefits in hypogonadal older men.
- Findings suggest that estrogen replacement may not enhance cognitive function in this specific population, contrary to some observations in postmenopausal women.
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