[Brain dysfunction in climacteric and prevention]

The risk of cardiovascular disease in women is relatively small before menopause but increases considerably afterwards. Postmenopausal women have on average a total cholesterol, LDL and VLDL cholesterol levels higher than premenopausal women; at the same time, HDL cholesterol serum level is lower. Postmenopausal estrogen replacement therapy (ERT) has been repeatedly proven to reduce the incidence of coronary heart disease as well as the mortality from cardiovascular disease. Furthermore, little is known about the potential risk of developing a stroke associated to hormonal changes involved in the menopause. Likewise the benefit of the ERT on reduction in stroke-legated mortality and morbidity is still debated. On the other hand, preliminary trials suggest a beneficial role of ERT in women with Alzheimer's disease (AD), probably due to the estrogen's cholinergic neurotrophic and neuroprotective effects. Moreover, recent reports suggest a possible additive beneficial effect of ERT to cholinergic treatments for AD In normal postmenopausal women the ERT not only improve cognitive and emotional functions but also increase verbal memory.