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Hormone therapy may offer short-term cognitive benefits, but long-term use, especially with progestogens, can reverse effects. Specific estrogen types and menopausal timing influence outcomes for brain function.

Keywords:
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Area of Science:

  • Neuroendocrinology
  • Cognitive Science
  • Women's Health

Background:

  • Discrepancies exist between basic science/observational studies and large treatment trials on sex steroids and brain function.
  • Observational studies may be confounded by recall bias and healthy user bias.
  • Treatment study outcomes may be influenced by menopausal factors, health status, and hormone type.

Approach:

  • Meta-analyses of treatment studies were conducted to evaluate hormone therapy's impact on cognition.
  • Investigated the influence of age, menopausal status, progestogen addition, and estrogen type.
  • Reviewed alternative treatments like testosterone and soy supplements.

Key Points:

  • Estrogen therapy shows mainly short-term (≤6 months) cognitive benefits, irrespective of age.
  • Prolonged hormone treatment, particularly with progestogens (e.g., medroxyprogesterone acetate), may reverse cognitive effects.
  • Estradiol demonstrated more positive cognitive effects than conjugated equine estrogens.
  • Two-thirds of studies found no association, potentially underestimating effects due to publication bias.

Conclusions:

  • Hormone therapy's cognitive effects are complex and depend on treatment duration, hormone type, and menopausal factors.
  • Women with early menopause (natural or surgical before 47) might benefit most, requiring further long-term safety studies.
  • More research is needed on testosterone and soy supplements for cognitive enhancement.