Neuropsychological effects of methyltestosterone in women using menopausalhormone replacement

To observe the effects of androgen replacement on neuropsychological measur es in menopausal women, healthy menopausal women already using replacement estrogen were studied in a randomized, double-blind, active placebo-control led, crossover comparison between two 8-week periods of treatment with (1) 0.625 mg oral esterified estrogen (E) alone and (2) in combination with 1.2 5 mg oral methyltestosterone (meT). After an initial baseline session, data were gathered at the end of two treatment periods. Scores on standardized psychological tests and computerized reaction times were compared between t reatments, as was an overall outcome score that combined all measures. Adde d meT significantly improved scores on a test of complex information proces sing, the Switching Attention Test, but not on other tests. Mean outcome sc ore showed no net change and wide variation. Fourteen subjects had outcome scores > 1 SD from the mean, and 21 had no change. In the estrogen alone co ndition, three measures predicted favorable outcome with added meT: surgica lly compromised ovarian function, fewer physical symptoms, and higher score on a self-image measure of creativity. Added meT treatment may improve com plex information processing. Despite wide disparities in outcome, an increa sed chance of overall improvement may be predicted by specific pretreatment measures.