Estrogen Replacement and Cognition: Ready for Prime Time?

While estrogen replacement therapy shows promise in helping post-menopausal women preserve important cognitive abilities such as memory, its effectiveness is still being questioned. In studies at the National Institutes of Health and at the University of California, Los Angeles, researchers have demonstrated that in some women, this hormone alters brain blood flow and improves performance on certain mental tests. But other studies are not as definitive, suggesting that improved cognitive abiliti

Harvey Black

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But don't advise treatment right now, some researchers say. "Not yet," says Pauline Maki, an investigator with the National Institute on Aging. "There haven't been any [looks] at large numbers of women on cognitive outcomes." Natalie Rasgon, assistant professor of psychiatry at UCLA and director of the menopause-related mood disorders research program, shares Maki's opinion. "It will take us some, probably a few more years to tease it out. But as a researcher I believe there are niches for estrogen. We just haven't hit on them," she says. In a two-year imaging study of women over 55,¹Maki found that those receiving estrogen replacement showed greater blood flow in the brain regions connected with memory while taking standard mental tests than did nontreated women. The estrogen users also scored better on memory tests.

Estrogen does more than increase blood flow. "Estrogen has very large and diverse effects on the central ...

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