Endocrine Abstracts

Background: Menopause marks the permanent cessation of periods for a woman. It is commonly associated with cognitive impairment. Oestrogens and progestins have been known to have a profound effect on the central nervous system and can exert neuroprotective effects on the cellular level. This led to the hypothesis that administration of oestrogens, progestins or a combination of both in the form of hormone replacement therapy (HRT) can have a protective or therapeutic effect against cognitive decline during and after the menopausal transition.

Objective: To conduct a systematic review of randomised controlled trials (RCTs) investigating the effect of HRT on the prevention or treatment of cognitive symptoms, cognitive decline and dementia in perimenopausal and postmenopausal women.

Materials and Methods: A pubmed, EMBASE and PsycINFO online search was conducted and the references of selected studies were searched during the ‘snowball’ process. 50 RCTs trials were included in the review.

Results: The majority of the RCTs revealed that HRT in menopausal women had a negligible effect on various cognitive measures and did not protect from the development of cognitive impairment or dementia. A few trials revealed that HRT actually had a deleterious effect by increasing the risk for cognitive decline and dementia to a statistically significant degree. Only a very small number of studies showed a positive effect of HRT on a number of cognitive tests.

Conclusion: HRT is not recommended as a preventive or therapeutic measure against cognitive decline and dementia and it is not recommended as a treatment to alleviate cognitive symptoms in menopausal women.