THE EFFECT OF SHORT-TERM ESTROGEN REPLACEMENT THERAPY ON COGNITION - A RANDOMIZED, DOUBLE-BLIND, CROSS-OVER TRIAL IN POSTMENOPAUSAL WOMEN

Objective: To evaluate the effect of estrogen replacement therapy on c ognitive functioning. Methods: The study consisted of two 3-month trea tment periods, one with estrogen and one with the placebo, in random o rder, separated by a 1-month wash-out period. The study group comprise d 70 healthy postmenopausal women, aged 47-65 years, with previous hys terectomy. Sixty-two women completed the study. Cognitive speed and ac curacy, attention, and memory were evaluated. Serum estradiol (E2) and FSH levels were controlled at the end of the estrogen, placebo, and w ash-out periods. Results: Most of the cognitive tests correlated with age: older women were slower and made more errors than younger women. Estrogen replacement therapy was not superior to the placebo in any te st of cognitive performance. In two out of ten visual detection tasks, recognition thresholds were longer with estrogen than with the placeb o (P < .001 and P = .004). On the most demanding test of working memor y, the reaction times (P = .045) and error rates (P = .043) differed b etween treatments, yet this finding proved to be an effect of learning rather than treatment. There was no correlation between cognitive per formance and serum E2 levels. Conclusion: Cognitive performance decrea sed with age. Short-term estrogen replacement therapy did not provide any advantage over the placebo in terms of improving the performance. (C) 1998 by The American College of Obstetricians and Gynecologists.