Estradiol Therapy May Benefit Overall Cognition in Postmenopausal Women

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Free cortisol levels significantly increased in the cold pressor test session, not the control session.
Free cortisol levels significantly increased in the cold pressor test session, not the control session.

According to a study published in the Journal of Clinical Endocrinology & Metabolism, postmenopausal women may experience additional benefits from estradiol therapy (ET) beyond the management of menopause-related symptoms. The therapy may limit the effects of stress on working memory and may aid in maintenance of proper hypothalamic-pituitary-adrenal reactivity

Researchers identified 42 postmenopausal women and assigned them to receive either 1 mg oral micronized 17β-estradiol (E2) (n=21) or placebo (n=21) daily within 6 years of menopause or after 10 years of menopause. 

In total, 4 groups were formed: early initiation-E2, early initiation-placebo, late initiation-E2, and late initiation-placebo. Groups were treated for a median of 5 years. The primary goal of the study was to determine the rate of change in the right carotid artery intima-media thickness. Women with an intact uterus received vaginal progesterone (estradiol group) or placebo gel (placebo group).

Investigators found that, “women assigned to estradiol exhibited blunted cortisol responses to [cold pressor test] compared [with those in the] placebo [group] (P =.017), and lesser negative effects of stress on working memory (P =.048).” 

Therefore, researchers concluded that estradiol therapy may provide a certain type of cognition protection in the presence of stress and may be beneficial to overall cognition and neural circuitry in women after menopause.

Reference

Herrera AY, Hodis HN, Mack WJ, Mather M. Estradiol therapy after menopause mitigates effects of stress on cortisol and working memory [published online November 2, 2017]. J Clin Endocrinol Metab. doi: 10.1210/jc.2017-00825

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