Cognitive function variations in postmenopausal women treated with continuous, combined HRT or tibolone. A comparison.
OBJECTIVE
To compare cognitive function in postmenopausal women receiving continuous hormone replacement therapy and those receiving tibolone.


METHODS
This was a 6-month, prospective, single-blind, single center, randomized study. A total of 50 healthy, postmenopausal women were enrolled. In the end, 40 women completed the 6-month follow-up. One group (23 subjects) received conjugated equine estrogens (CEE), 0.625 mg/d, and medroxyprogesterone acetate (MPA), 5 mg/d. The other group (17 subjects) received tibolone, 2.5 mg/d. Their serum estradiol levels and Cognitive Abilities Screening Instrument (CASI) and Mini-Mental State Examination (MMSE) scores were obtained before starting and after 3 and 6 months of treatment.


RESULTS
There was a significant increase in the serum estradiol level in the CEE + MPA group, especially after 3 months of treatment, but there was no increase in the estradiol level in the tibolone group. The CASI and MMSE scores of the CEE + MPA group and the tibolone group after 3 and 6 months of treatment showed no significant difference between the two groups apart from the MMSE at the 3-month follow-up. We saw an increasing trend in CASI and MMSE scores after treatment in both groups; however, the increases were not statistically significant. The rate of increase of both CASI and MMSE scores in the CEE + MPA group was greater than in the tibolone group, though the difference was not significant.


CONCLUSIONS
This preliminary study demonstrated that both CEE + MPA and tibolone can preserve cognitive function and may be able to prevent cognitive decline in postmenopausal women during short-term treatment. Our results also show that continuous, combined CEE + MPA seems to be marginally more effective than tibolone in improving cognitive processes; however, long-term study is needed to follow-up such effect.
Pan
Hsien-An
HA
Departments of Obstetrics and Gynecology, Public Health and Neurology, National Cheng Kung University Hospital, Tainan, Taiwan.
Wang
Shan-Tair
ST
Pai
Ming-Chyi
MC
Chen
Chih-Hung
CH
Wu
Meng-Hsing
MH
Huang
Ko-En
KE
D003071:Cognition; D003072:Cognition Disorders / Q000517:prevention & control*; D003131:Combined Modality Therapy; D020847:Estrogen Receptor Modulators / Q000008:administration & dosage / Q000494:pharmacology*; D004966:Estrogens, Conjugated (USP) / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D020249:Hormone Replacement Therapy; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage / Q000494:pharmacology*; D008609:Mental Status Schedule; D008875:Middle Aged; D009652:Norpregnenes / Q000008:administration & dosage / Q000494:pharmacology*; D017698:Postmenopause; D045167:Progesterone Congeners / Q000008:administration & dosage / Q000494:pharmacology*; D016037:Single-Blind Method
D020847:Estrogen Receptor Modulators; D004966:Estrogens, Conjugated (USP); D009652:Norpregnenes; D045167:Progesterone Congeners; D017258:Medroxyprogesterone Acetate; C027385:tibolone