It is an exciting challenge to be a practitioner in women’s health care. Although traditionally held benefits of hormone replacement therapy (HRT) are being challenged, compelling evidence of previously unappreciated benefits is emerging. This phenomenon is most dramatic in the study of cognition. The impact of sex steroids, most notably estrogen, on the central nervous system (CNS) is profound and diverse. Currently, there are over 300 journals published annually that are devoted to the study of neuroscience. Moreover, it is a rare occurrence for one of these journals not to address this subject.
This article summarizes the current data describing the relationship between reproductive hormones and cognition on women during the late reproductive years and the perimenopause. The wealth of data on the relationship between hormones and other brain functions like mood, behavior, coordination, sexuality, or sleep are not reviewed. A review of hormonal therapy in patients with estab- lished neurodegenerative diseases like Alzheimer’s disease or Parkinson’s disease is also not provided. The interested reader is encouraged, however, to pursue these subjects and it is hoped those issues can be addressed in future publications.
Cognition: the often overlooked symptom of the menopausal syndrome
Cognition is a term describing a variety of brain functions including memory, learning, language, attentiveness, reasoning, and motor speed. The Study of Women’s Health Across the Nation recently confirmed that memory problems rank among the most common complaints of women experiencing menopause in the United States regardless of their racial background. As a result of tech- niques developed during the last decade, clinicians are beginning to understand the association between hypoestrogenism and memory problems. The devel- opment of a vast knowledge base has enabled clinicians to generate physiologic
* Corresponding author. Specialty Care for Women, 1255 East Street, Suite 201, Redding, CA 96001.
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hypotheses that are being tested experimentally. Most of the data strongly suggest that HRT promotes brain functioning in women as they develop and protects brain functioning as they age. This information has become even more important as the dramatic growth of the post – reproductive-aged population is seen.