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Hormone Drugs Don’t Harm Brain for Some Menopausal Women

Hormone therapy doesn’t appear to have a harmful effect on cognitive function in younger postmenopausal women, according to a study that also showed the treatment didn’t benefit the brain.

Women 50 to 55 years old who were given estrogen or estrogen plus progestin had similar scores on tests of memory and other mental processes as those taking a placebo, according to research published yesterday in JAMA Internal Medicine.

An earlier study in women ages 65 and older linked the hormone treatments to cognitive decline and dementia, the authors said. The new findings show that taking the therapies for a short time earlier in menopause to treat symptoms doesn’t harm the brain, said Mark Espeland, the lead study author.

“These findings are still not definitive but they are certainly the best evidence yet that the negative effects on the brain of hormone therapy in older women do not extend to younger women,” said Francine Grodstein, an associate professor of medicine at Brigham and Women’s Hospital in Boston who wrote an accompanying editorial in the journal. “Hormone therapy remains one of the best treatments for menopausal symptoms.”

Menopausal women take hormone treatments to relieve hot flashes, night sweats and vaginal symptoms. The hormone replacement therapies should be taken at the lowest dose and for the shortest duration needed to relieve symptoms, according to U.S. recommendations. Some of the treatments may increase a woman’s risk of breast cancer, heart disease and stroke.

Breast Cancer

More than 6 million women took New York-based Pfizer Inc.’s Premarin and Prempro, a combination of estrogen and progestin, to treat their menopausal symptoms before they were linked in 2002 to health concerns such as breast cancer.

The study from the Women’s Health Initiative Memory Study of Younger Women is an extension of the Women’s Health Initiative. The research included 1,326 postmenopausal women who received hormone therapy or placebo when they were 50 to 55 years old for about seven years. Researchers conducted telephone interviews to measure cognitive function over the following seven years after they stopped treatment.

“Based on our data, there appears to be no harm and no benefit to women’s cognition,” Espeland, a professor of public health at Wake Forest University, in Winston-Salem, North Carolina, said in a telephone interview. He said they are continuing to follow these women to see if there are any long-term cognition problems related to hormone therapy use and what women can do in midlife to preserve mental function as they age.

The research was funded by the U.S. National Institutes of Health.

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