Estradiol Therapy May Benefit Overall Cognition in Postmenopausal Women

A brain and a stethoscope
A brain and a stethoscope
There may be other roles of estradiol therapy besides relief from menopause-related symptoms, including limiting effects of stress on working memory.

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.

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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