- Hormone therapy may affect changes in the brain that occur during menopause.
- A recent study has shown that hormone therapy may help improve “brain fog” symptoms during menopause.
- Another study found that hormone therapy may improve mood changes that are often associated with menopause.
- Other research has alleviated long-standing concerns over a possible link between menopause hormone therapy and dementia.
Menopause hormone therapy (MHT), also known as hormone replacement therapy (HRT), helps manage various menopause symptoms.
Currently, MHT is approved by the Food and Drug Administration (FDA) to help relieve hot flashes, night sweats, vaginal dryness, and dyspareunia (pain during sex).
However, recent research has found that MHT may also help improve mental symptoms like “brain fog” and mood changes.
Other research also found that MHT does not affect dementia risk. This research followed the FDA’s removal of the black box warning on these products, which suggested they may increase the risk.
Together, these studies show that MHT may help people experiencing menopause in ways not previously realized and that it is generally safe to use.
Hormone therapy may ease menopause ‘brain fog’
Research published in Scientific Reports on September 1 suggests that an estrogen hormone treatment that combines estriol and progesterone may help ease the symptoms of brain fog during menopause.
Brain fog may involve memory lapses, difficulty concentrating, and slower thinking.
Just about two-thirds of women experience cognitive difficulties, like brain fog, during the menopausal transition. However, there is currently no Food and Drug Administration (FDA)- approved treatment for these symptoms.
This study was an observational case series that followed 20 menopausal women with an average age of 53. Each participant was given a baseline assessment for cognitive symptoms prior to treatment.
They were then treated for 12 months with a customized regimen of estriol and progesterone.
Estriol is a natural form of estrogen that occurs during pregnancy and has been used in Europe and Asia to treat other symptoms of menopause.
After 12 months, the participants reported significant reductions in:
- brain fog
- concentration
- working memory
- verbal memory
- processing speed
- problem solving
“Estrogen plays a well-documented role in protecting the brain, yet there are still no approved type and dose of treatment that specifically targets the cognitive symptoms so many women experience during menopause,” Rhonda Voskuhl, MD, neurologist, member of the Comprehensive Menopause Center at UCLA Health, and senior study author, said in a press release.
“Women are often told to simply live with brain fog, when in fact there is a neuroscience basis for it, and potentially a way to address it. That gap in care is what motivated us to look more closely at estriol,” Voskuhl said.
This was a small, preliminary case series without a placebo group or randomization. More research is needed to confirm the benefits for cognitive symptoms.
Key points
- Brain fog is a common symptom of menopause with no approved treatment.
- A recent study found that hormone therapy with estriol and progesterone may help improve cognitive symptoms during menopause.
- More research is needed to confirm the effects of hormone therapy on cognitive symptoms.
Hormone therapy may help with menopause mood changes
A study published September 9 in Menopause, the journal of the Menopause Society, showed that hormone therapy may help improve mood changes in women in midlife.
The researchers noted that mood disturbances, such as depression, irritability, anxiety, and mental exhaustion, affect up to 68% of women during menopause.
“The erratic changes and loss of estrogen associated with this hormonal transition can lower serotonin and dopamine levels, which [are] associated with depression and cognitive changes, including poor concentration, brain fog, and memory loss,” said Sherry Ross, MD, board certified OB/GYN and Women’s Health Expert at Providence Saint John’s Health Center in Santa Monica, CA, who wasn’t involved in the study.
The study included 260 individuals with an average age of 52 years. Just over half of the participants had a history of anxiety or depression, and 24% were using an antidepressant medication at the start of the study.
Each participant completed the Menopause Rating Scale (MRS) both before and after initiating hormone therapy for FDA-approved indications, such as hot flashes and night sweats.
The average follow-up during the study was 4.5 months. Between the baseline and the follow-up, there was a significant reduction in the MRS psychological scores. The percentage of participants with severe mood symptoms decreased from 62.3% to 24.6%.
Treatment response didn’t appear to differ by age, menopausal stage, psychiatric history, or antidepressant use. These findings suggest that hormone therapy may help improve mood symptoms in midlife, especially for those with higher severity of symptoms before treatment.
“This study supports the evidence that starting hormone therapy for the typical disruptive symptoms of menopause may bring collateral benefits, including improvement in mood,” Ross said. “Communicating with your healthcare provider is always best to manage your symptoms and prepare yourself properly for this next stage of life.”
Key points
- A recent study showed that hormone therapy may help improve mood changes associated with menopause.
- The biggest improvement was seen in those with more severe symptoms before beginning treatment.
- Improvement with hormone therapy was seen despite age, menopause stage, and psychiatric history.
Menopause hormone therapy not linked to dementia
For decades, women have been warned about the serious potential risks associated with menopause hormone therapy (MHT). This included an FDA “black box” warning citing complications like cardiovascular disease, cancer, and dementia.
However, a recent meta-analysis commissioned by the World Health Organization (WHO) that included data from more than a million women, and was published in The Lancet Healthy Longevity, found that MHT neither increased nor decreased dementia risk.
“The World Health Organisation currently provides no guidance on MHT and dementia risk, leaving a critical gap for women, clinicians, and policymakers. Our work will help inform upcoming WHO guidelines on reducing the risk of cognitive decline and dementia,” Melissa Melville, a PhD candidate and aging researcher in the Department of Clinical Health Psychology at the University College London, and first author of the study, told Healthline in a previous interview.
In the same interview, Melville stressed that the importance of this work is twofold: for clinicians, there is an urgent need for higher-quality research, and for patients, decisions about MHT should be guided by symptoms and well-established benefits and risks.
Key points
- A new meta-analysis has helped to ease long-standing fears regarding the association between menopause hormone therapy and dementia.
- The analysis reviewed data from more than a million women and found that MHT neither raises nor decreases the risk of dementia.
- The researchers noted that decisions about MHT should be guided by symptoms and well-established benefits and risks.
Hormone Therapy May Help Improve Menopause Brain Fog, Mood Changes
Source: Pinoy Lang Sakalam
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