Mounting evidence of estrogen's role in preventing cognitive decline is affecting women's decisions on hormone replacement therapy (HRT), a symposium panel recently told attendees of the Academy of Psychosomatic Medicine's annual meeting in New Orleans. But causes of variability among women in estrogen's impact on cognition have not yet been identified. Moreover, the continuing emergence of selective estrogen receptor modulators (SERMs), drugs that can imitate the hormone's positive effects while reducing its adverse effects, will require extensive testing to find out how each agent affects the brain.

Mary Sano, associate professor of clinical neuropsychology at Columbia University College of Physicians and Surgeons, noted that estrogen's apparent boost to cognition has been demonstrated in women approaching menopause or in the early stages of it, but not at other stages of life. Questions that remain are, what happens to cognition when the hormone is administered later in life, and what effect...

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