Hormone therapy in early menopause does not affect memory but increases sexuality

Last Updated: 2007-09-24 19:22:16 -0400 (Reuters Health)

NEW YORK (Reuters Health) - In the Cognitive Complaints in Early Menopause Trial (COGENT), hormone therapy in recently postmenopausal women had no effect on cognitive function, but was associated with significant increases in sexual interest and thoughts.

Dr. Pauline Maki, a psychologist at the University of Illinois at Chicago, and the other COGENT trialists restricted enrollment to women between 45 and 55 years old with subjective cognitive complaints and whose last period had occurred 1 to 3 years ago.

The 180 subjects were randomized to hormone therapy (0.625 mg conjugated equine estrogen plus 2.5 mg medroxyprogesterone acetate) or matching placebo daily for 4 months. The study group reports their findings in the September 25th issue of Neurology.

In the authors' intent-to-treat analysis, both groups experienced changes from baseline in the primary efficacy endpoints (worsening of measures of memory and improvements in attention and subjective cognition).

However, the researchers observed no significant differences between the two treatment groups in measures of cognition. There were also improvements for many of the secondary endpoints (verbal fluency, working memory, mood, and quality of sleep), but again, with no significant differences based on hormone therapy.

This study "suggests that hormone therapy is associated with both modest beneficial and detrimental effects across cognitive domains," Dr. Maki and associates report.

However, hormone therapy was associated with significant increases in sexual thoughts and level of sexual interest compared with placebo. As Dr. Maki commented in a journal statement: "The level of sexual interest reported by women on hormone therapy increased 44% and their number of sexual thoughts increased 32% compared to the placebo group."

Those affected by hot flashes and night sweats at baseline also responded positively to hormone therapy, as did their quality of life scores, the research team found.

Interpretation of these data should take into account the reduced enrollment that followed publication of the Women's Health Initiative, which "likely rendered this study underpowered to decisively distinguish between hormone therapy effects versus placebo," they advise.

Still, Dr. Maki's team maintains that the results of COGENT should not be ignored, as it is "the largest study to date examining the effects of hormone therapy on cognitive function in recently menopausal women."

Neurology 2007;69:1322-1330.