Low-dose conjugated equine estrogens elevate circulating neurotransmitters and improve the psychological well-being of menopausal women.
OBJECTIVE
To assess the effect of low-dose conjugated equine estrogens (E) on circulating neurotransmitters and the efficacy for the treatment of psychological symptoms.


METHODS
Controlled comparative clinical study.


METHODS
Endocrine Research Unit, Instituto Mexicano del Seguro Social, Mexico.


METHODS
Thirty postmenopausal women received conjugated equine E. Ten women acted as a comparison group.


METHODS
Conjugated equine E, 0.312 mg/day, for 21 days per cycle during six cycles and added chlormadinone acetate, 2 mg/day, for the last 5 days of each cycle. Green scale for climateric women and Blatt-Kupperman Menopausal Index were used for measuring psychological well-being.


METHODS
Serum levels of dopamine (DA), noradrenaline, serotonin, and beta-endorphin were quantified by specific assays at baseline and at the end of treatment.


RESULTS
Low baseline levels of DA, serotonin, and beta-endorphin increased significantly (P<.001) from 181.9 +/- 47.8 pg/mL to 202.9 +/- 32.8 pg/mL (mean +/- SD); from 206.4 +/- 94.2 ng/mL to 279.2 +/- 67.9 ng/mL; from 11.2 +/- 1.8 pmol/L to 13.8 +/- 2.4 pmol/L, respectively, after conjugated equine E. In parallel, augmented baseline noradrenaline levels diminished significantly (P<.05) from 30.2 +/- 4.7 ng/mL to 24.0 +/- 4.7 ng/mL. All neurotransmitter levels had a significant correlation with 17beta-E(2) concentrations at the end of the study. Alleviation of psychological symptoms was observed in all but eight treated women.


CONCLUSIONS
Low-dose conjugated equine E associated with periodic administration of chlormadinone acetate elicited favorable changes in neurotransmitters and relieved psychological symptoms.
Zárate
Arturo
A
Endocrine Research Unit, National Medical Center, Instituto Mexicano del Seguro Social, Mexico City, Mexico. azarat@mediweb.com.mx
Fonseca
Eugenia
E
Ochoa
Raquel
R
Basurto
Lourdes
L
Hernández
Marcelino
M
D002395:Catecholamines / Q000097:blood; D004305:Dose-Response Relationship, Drug; D004958:Estradiol / Q000097:blood; D004967:Estrogens / Q000008:administration & dosage*; D004966:Estrogens, Conjugated (USP) / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008593:Menopause / Q000097:blood* / Q000523:psychology*; D008603:Mental Health; D008875:Middle Aged; D018377:Neurotransmitter Agents / Q000097:blood*; D012701:Serotonin / Q000097:blood; D016896:Treatment Outcome; D001615:beta-Endorphin / Q000097:blood
D002395:Catecholamines; D004967:Estrogens; D004966:Estrogens, Conjugated (USP); D018377:Neurotransmitter Agents; D012701:Serotonin; D004958:Estradiol; D001615:beta-Endorphin