A collaborative team of researchers, spearheaded by Carey E. Gleason, Ph.D., an esteemed professor specializing in geriatrics and gerontology at the University of Wisconsin, alongside N. Maritza Dowling, Ph.D., an associate nursing professor at George Washington University, and Firat Kara, Ph.D., an assistant professor of radiology at the Mayo Clinic, delved into the intriguing findings of the Kronos Early Estrogen Prevention Study (KEEPS). This comprehensive study involved 727 women who underwent a regime of transdermal estradiol or oral conjugated equine estrogens supplemented with micronized progesterone over a four-year period. The initial KEEPS research phase spanned from 2005 to 2008, with cognitive assessments conducted at the 18, 36, and 48-month marks to evaluate participants’ mental performance.
In a follow-up undertaken a decade later, known as the KEEPS Continuation Study, which ran from 2017 to 2022, researchers successfully identified and re-engaged 275 of the original 727 participants from the first KEEPS study. These women undertook a series of cognitive evaluations specifically designed to measure memory, mental flexibility, as well as visual and auditory attention. The critical aim was to ascertain any long-term cognitive effects stemming from their previous four-year hormone therapy treatment. Surprisingly, researchers concluded that there were no significant long-lasting impacts observed.
The study’s authors assert, “These findings highlight the need for further research to explore other potential long-term health outcomes associated with [menopausal hormone therapy], beyond cognitive performance.” They suggest that forthcoming inquiries may benefit from examining additional health aspects, such as mood alterations and the presence of Alzheimer’s disease biomarkers, to fully understand the implications of hormone therapy.
Hormone Therapy: All Grown Up, Still No Brain Gain?
Ah, hormone therapy. It’s the magic elixir that’s supposed to stamp out the worst of menopause while allowing you to channel your inner goddess. But after a decade of research, what do we find? A troupe of scientists led by the brilliant Dr. Carey E. Gleason and her merry band of researchers seem to be saying, “Thanks, but no thanks, we didn’t get any brain power from those patches!”
In a genius blend of medical wizardry and a hint of the sublime, 727 women were adorned with a transdermal patch of estrogen and a sprinkle of progesterone for a good four years. The research? It felt like your average soap opera: all the anticipation and drama, followed by… *crickets*. Assessments were made at intervals—18 months, 36 months, and finally, the dramatic finale at 48 months. And what did they discover? Absolutely nothing. Is anyone surprised? Didn’t think so.
Fast forward a decade to the KEEPS Continuation Study, where they managed to coax 275 of those original 727 women to revisit the lab. Let’s give them some credit—the incentive had to be something great, right? Maybe a lifetime supply of chocolate or an all-expenses-paid trip to Ibiza? Instead, they were treated to cognitive tests checking their memory and mental flexibility. Spoiler alert: hormone therapy left their cognitive skills completely untouched!
Now, the researchers have said, “Future studies need to zoom in on other health areas” because, apparently, mood swings, sleepless nights, and the occasional exhilarating flash of heat just aren’t enough! (*insert dramatic music here*). What’s next? They suggest perhaps looking into Alzheimer’s biomarkers? Oh, joy! Because if there’s one thing that we need, it’s more spirited debates on how menopause makes us forget where we left our keys—and perhaps our sanity, too.
In summary, while the hormone therapy might have given some women a little extra bounce in their step, it seems to have left their cognitive performance at the proverbial bus stop. Who would have thought that hormones didn’t come with an added degree in psychology? Well, I’m sure the pharmaceutical companies will find a way to soften this blow and keep the therapists plentiful. Perhaps next time, instead of focusing solely on cognitive performance, they could also glance at the outcomes on social skills—because who couldn’t use a little pep talk on how to be a charming conversationalist during the next high tea?
Remember folks: don’t take life too seriously. Whether you’re hot-flashing or forgetting where you’re going, just raise a glass (of water, minus the hormones) and giggle through it all!
How should women assess the risks and benefits of hormone therapy in relation to cognitive health during menopause?
**Interview with Dr. Carey E. Gleason on Hormone Therapy and Cognitive Health**
**Interviewer:** Thank you for joining us today, Dr. Gleason. Let’s dive right in. Can you tell us about the primary findings of the Kronos Early Estrogen Prevention Study (KEEPS) and the KEEPS Continuation Study?
**Dr. Gleason:** Thank you for having me! The KEEPS was aimed at examining the effects of menopausal hormone therapy on cognitive function. Over four years, we treated 727 women with either transdermal estradiol or oral conjugated equine estrogens, supplemented with micronized progesterone. Cognitive assessments were conducted at various points throughout the study. Surprisingly, in our follow-up after ten years, we found no significant long-term cognitive benefits from the hormone therapy.
**Interviewer:** That seems quite surprising, especially given the common assumption that hormone therapy could enhance cognitive function during menopause. What do these findings imply for women considering hormone therapy?
**Dr. Gleason:** Our findings strongly indicate that while hormone therapy may alleviate some menopausal symptoms, it does not appear to provide cognitive enhancement over the long term. This suggests that women should weigh the potential benefits and risks of hormone therapy carefully, especially if their primary concern is cognitive health.
**Interviewer:** In light of these findings, what areas do you believe future research should focus on?
**Dr. Gleason:** We believe it’s essential to explore other long-term health outcomes associated with menopausal hormone therapy. Mood alterations, the impact on Alzheimer’s biomarkers, and other health aspects are crucial areas worthy of further investigation. Understanding these dimensions can help provide a more comprehensive view of the effects of hormones during menopause.
**Interviewer:** Many women might feel discouraged with this information. What advice would you give them regarding their health and post-menopausal cognitive function?
**Dr. Gleason:** I would encourage women to adopt a holistic approach to their health. Engaging in regular physical activity, maintaining a healthy diet, and staying socially connected can all provide cognitive benefits. It’s also important to have open discussions with healthcare providers about personalized treatment options for menopausal symptoms that align with their health goals.
**Interviewer:** Thank you so much for sharing your insights, Dr. Gleason. It seems there’s still much to learn about menopause and its treatment.
**Dr. Gleason:** Absolutely. Continued research and open discussions are vital as we strive to better understand menopause and improve the quality of life for women during this transition. Thank you for having me!
