Monday
Sep122011

Helping Moods and Cognitive Function

 

There is considerable evidence that estrogen has a positive effect on mood and cognitive function (memory and thinking processes).  Although, there is a debate as to the degree of help that estrogen provides.
Mood
In general, estrogen’s greatest effect on mood is seen in perio-menopause (those few years just before menopause) when hormone levels are very irregular.  Because  perio-menopausal women are still menstruating, there is often no need for the addition of progesterone to balance the stimulatory effect of estrogen on the uterus. 
Clinical depression and panic attacks do not seem to be related to menopause,  so estrogen would not be the drug of choice for their treatment in post-menopausal women.
Memory
When it comes to short term memory, the benefits of estrogen are not conclusive.  The same is true of cognitive function.  Some studies show an improvement in verbal domains but not in numerical or spatial domains. Other studies show no improvement at all.
Alzheimer's Disease
The most evidence of estrogen having an effect on cognitive function is in preventing Alzheimer’s disease. The benefits seem to be proportional to the length of time on estrogen.  However, a recent study revealed that there appears to be no benefit in estrogen treatment for someone who already has Alzheimer’s.
HRT Therapy
Any benefit of estrogen on mood may be offset by the progesterone compound that most women need to take along with the estrogen.  When this progesterone compound is the synthetic progestin Provera (medroxyprogesterone), it tends to eliminate much of the benefits on mood.  Micronized or natural progesterone does not seem to have the amount of mood problems as that of synthetic progestins.
We will learn much more  about estrogen and cognitive function in five years when the second phase of the Women’s Health Initiative Study is published.
What are your needs?
Ask yourself:
Are you having mood swings during perio-menopause?
Do you have a family history of Alzheimer’s?
Additions/alternatives to HRT
Alternatives treatments for mood swings could be a Web site in itself.  Stress reduction techniques, cognitive therapy, and yoga are but a few of the many useful activities to help with mood swings. When dealing with short-term memory loss, it is important to realize that we all experience this to some degree as we age. Try to focus on the many things you remember instead of the few you forget.
Supplements may be of some help for cognitive function.  St. John’s wort has been shown to be effective in mild depression, although prolonged depression should always be treated by a professional. Kava has some benefit as an anti-anxiety agent. Valerian can help with sleep.  Although gingko has been shown to help with memory loss, its benefits seem to be greater in older people who have lost some blood flow to the brain.
Benefit to Risk 
Based on current statistics, when HRT is used for mood or memory:  
                       
The benefits are probably greater than the risks:  
if you are in perio-menopause and experiencing mood swings.
if you are post-menopausal and having cognitive problems and are using HRT for less than 5 years.
 
The benefits are possibly greater than the risks:  
if you are post-menopausal and have an immediate family history of Alzheimer’s disease. 
 
The risks are probably greater than the benefits:  
if you are postmenopausal and using HRT to treat memory and cognitive functions for longer than 5 years..