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Effects of different postmenopausal hormone therapy regimens on cerebral blood flow and cognitive functions

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Abstract

Introduction

The purpose of this study was to compare the effects of different postmenopausal hormone therapy regimens, namely conjugated equine estrogens (CEE), CEE plus medroxyprogesterone acetate (MPA), tibolone, and raloxifene on cerebral blood flow and cognitive functions.

Methods

A total of 64 healthy postmenopausal women admitted to the Department of Obstetrics and Gynecology, Cumhuriyet University, Turkey were included in this study. Patients were divided into five groups with respect to the treatment protocols: CEE 0.625 mg/day (n=13); CEE 0.625 mg/day + MPA 2.5 mg/day (n=14); tibolone 2.5 mg/day (n=11); raloxifene 60 mg/day (n=9); and control (n=17). The CEE group included only women with surgical menopause. Those who were on hormonal therapy, who had previously used hormonal therapy, who had neurological disorders, or who did not accept the longterm follow-up were excluded from the study. Demographic and clinic characteristics were recorded. Before starting the therapy regimens, cerebral blood flow was evaluated by internal carotid artery and middle cerebral artery peak systolic velocity, and pulsatility index measurements via Doppler ultrasonography. Cognitive functions were evaluated by the Standardized Mini-Mental Test. The mean follow-up period was 10.9±2.4 months, ranging between 8 and 16 months. After the follow-up period, the cerebral blood flow, and cognitive function of each woman was re-evaluated.

Results

Demographic and clinical characteristics of the women were not significantly different between the study groups (P>0.05). There were no significant differences between the pretreatment and posttreatment values for cerebral blood flow indices and cognitive function scores in any of the study groups (P>0.05).

Conclusion

Different postmenopausal hormone therapy regimens have not revealed any significant effects on either cerebral blood flow or cognitive function.

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References

  1. Blake J. Menopause: evidence-based practice. Best Pract Res Clin Obstet Gynaecol. 2006;20:799–839.

    Article  PubMed  Google Scholar 

  2. Hulley S, Grady D, Bush T, et al. Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women. JAMA. 1998;280:605–613.

    Article  PubMed  CAS  Google Scholar 

  3. Rossouw JE, Anderson JL, Prentice RL, et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial. JAMA. 2002;288:321–333.

    Article  PubMed  CAS  Google Scholar 

  4. Paganini-Hill A, Henderson VW. Estrogen deficiency and risk of Alzheimer’s disease in women. Am J Epidemiol. 1994;140:256–261.

    PubMed  CAS  Google Scholar 

  5. van Duijn CM. Hormone replacement therapy and Alzheimer’s disease. Maturitas. 1994;31:201–205.

    Article  Google Scholar 

  6. Kawas C, Resnick S, Morrison A, et al. A prospective study of estrogen replacement therapy and the risk of developing Alzheimer’s disease: the Baltimore Longitudinal Study of Aging. Neurology. 1997;48:1517–1521.

    PubMed  CAS  Google Scholar 

  7. Gao S, Hendrie HC, Hall KS, Hui S. The relationships between age, sex, and the incidence of dementia and Alzheimer disease: a meta-analysis. Arch Gen Psychiatry. 1998;55:809–815.

    Article  PubMed  CAS  Google Scholar 

  8. Fillit H, Luine V. The neurobiology of gonadal hormones and cognitive decline in late life. Maturitas. 1997;26:159–164.

    Article  PubMed  CAS  Google Scholar 

  9. Panidis DK, Matalliotakis IM, Rousso DH, Kourtis AI, Koumantakis EE. The role of estrogen replacement therapy in Alzheimer’s disease. Eur J Obstet Gynecol Reprod Biol. 2001;95:86–91.

    Article  PubMed  CAS  Google Scholar 

  10. Gibbs RB. Estrogen replacement enhances acquisition of a spatial memory task and reduces deficits associated with hippocampal muscarinic receptor inhibition. Horm Behav. 1999;36:222–233.

    Article  PubMed  CAS  Google Scholar 

  11. Bishop J, Simpkins JW. Estradiol enhances brain glucose uptake in ovariectomized rats. Brain Res Bull. 1995;36:315–320.

    Article  PubMed  CAS  Google Scholar 

  12. Ohkura T, Teshima Y, Isse K, et al. Estrogen increases cerebral and cerebellar blood flows in postmenopausal women. Menopause. 1995;2:13–18.

    Article  Google Scholar 

  13. Darj E, Bakos O, Naessen T, Persson I. Ultrasonographic blood flow measurement in the carotid arteries in postmenopausal women. Gynecol Obstet Invest. 1999;47:20–25.

    Article  PubMed  CAS  Google Scholar 

  14. Penotti M, Farina M, Castiglioni E, et al. Alteration in the pulsatility index values of the internal carotid and middle cerebral arteries after suspension of postmenopausal hormone replacement therapy: a randomized crossover study. Am J Obstet Gynecol. 1996;175:606–611.

    Article  PubMed  CAS  Google Scholar 

  15. Jackson S, Vyas S. A double blind, placebo controlled study of postmenopausal hormone replacement therapy and carotid artery pulsatility index. Br J Obstet Gyneocol. 1998;105:408–412.

    CAS  Google Scholar 

  16. Sherwin BB. Estrogen and cognitive functioning in women. Proc Soc Exp Biol Med. 1998;217:17–22.

    PubMed  CAS  Google Scholar 

  17. Hogervorst E, Williams J, Budge M, Riedel W, Jolles J. The nature of the effect of female gonadal hormone replacement therapy on cognitive function in postmenopausal women: a meta-analysis. Neuroscience. 2000;101:485–512.

    Article  PubMed  CAS  Google Scholar 

  18. Miller MM, Franklin KB. Theoretical basis for the benefit of postmenopausal estrogen substitution. Exp Gerontol. 1999;34:587–604.

    Article  PubMed  CAS  Google Scholar 

  19. Lund CO, Nilas L, Dalsgaard T, Pedersen SH, Ottesen B. Acute effects of tibolone on cerebral vascular reactivity in vitro. Climacteric. 2003;6:228–237.

    Article  PubMed  CAS  Google Scholar 

  20. Fluck E, File SE, Rymer J. Cognitive effects of 10 years of hormone-replacement therapy with tibolone. J Clin Psychopharmacol. 2002;22:62–67.

    Article  PubMed  CAS  Google Scholar 

  21. Setacci C, Marca A, Agricola E, et al. Effects of the selective estrogen receptor modulator, raloxifene, on carotid artery pulsatility index in postmenopausal women. Am J Obstet Gynecol. 2002;186:832–835.

    Article  PubMed  CAS  Google Scholar 

  22. Low LF, Anstey KJ, Jorm AF, Christensen H, Rodgers B. Hormone replacement therapy and cognition in an Australian representative sample aged 60–64 years. Maturitas. 2006;54:86–94.

    Article  PubMed  CAS  Google Scholar 

  23. Low LF, Anstey KJ. Hormone replacement therapy and cognitive performance in postmenopausal women-a review by cognitive domain. Neurosci Biobehav Rev. 2006;30:66–84.

    Article  PubMed  CAS  Google Scholar 

  24. Shumaker SA, Legault C, Kuller L, et al. Conjugated equine estrogens and incidence of probable dementia and mild cognitive impairment in postmenopausal women: Women’s Health Initiative Memory Study. JAMA. 2004;291:2959–2968.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Celal Bayar University Faculty of Medicine, Kadin Hastaliklari ve Dogum Anabilim Dali, Manisa, Turkey

    Tevfik Guvenal

  2. Department of Neurology, Anadolu Hospital, Antalya, Turkey

    Aysenur Durna

  3. Department of Obstetrics and Gynecology, Sivas State Hospital, Sivas, Turkey

    Omur Erden

  4. Department of Obstetrics and Gynecology, Buca Medical Center, Izmir, Turkey

    Feray Guvenal

  5. Department of Obstetrics and Gynecology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey

    Meral Cetin & Ali Cetin

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  1. Tevfik Guvenal
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  2. Aysenur Durna
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  3. Omur Erden
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  4. Feray Guvenal
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  5. Meral Cetin
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  6. Ali Cetin
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Correspondence to Tevfik Guvenal.

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Guvenal, T., Durna, A., Erden, O. et al. Effects of different postmenopausal hormone therapy regimens on cerebral blood flow and cognitive functions. Adv Therapy 26, 805–811 (2009). https://doi.org/10.1007/s12325-009-0058-x

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  • DOI: https://doi.org/10.1007/s12325-009-0058-x

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