Hormone Therapy's Effects on Brain

by Teri Robert, Lead Expert

For those with Migraines, the question of whether to use hormone therapies is one we often look at only in terms of the impact it will have on Migraine frequency and severity. There are, however other issues that need to be considered as well.

Two new studies show that hormone therapy (HT) for women is linked to brain shrinkage, but not to the small brain lesions that are the first sign of cerebrovascular disease. The studies are published in the January 13, 2009, print issue of Neurology®, the medical journal of the American Academy of Neurology.

Earlier studies showed that estrogen with or without added progestin increased the risk for developing dementia and cognitive decline, or difficulty with thinking skills and memory in women age 65 and older.

These new studies aimed to look at how the hormones might affect memory and thinking skills. The studies involved participants of the Women’s Health Initiative* hormone therapy clinical trials who also agreed to participate in a substudy called the Women’s Health Initiative Memory Study. These studies were stopped earlier than planned when researchers found that the hormone therapy increased health risks and failed to prevent heart disease.

Researchers took MRI brain scans of 1,400 women ages 71 to 89 one to four years after the Women’s Health Initiative hormone studies ended. They found women who had taken estrogen with or without progestin had smaller brain volumes in two areas of the brain than the women who had taken a placebo. Brain volume was 2.37 cubic centimeters lower in the frontal lobe in the women taking estrogen and .10 cubic centimeters lower in the hippocampus. Both areas are involved in thinking and memory skills, and loss of volume in the hippocampus is a risk factor for dementia.

“These effects were most apparent in women who may already have had some memory problems before they started taking hormones,” said study author Susan Resnick, PhD, of the National Institute on Aging in Baltimore, MD. “This suggests that estrogen may adversely affect thinking skills among women whose brains may already be beginning a neurodegenerative disease process.”

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