Effects of different postmenopausal hormone therapy regimens on cerebral blood flow and cognitive functions.
BACKGROUND
The purpose of this study was to compare the effects of different postmenopausal hormone therapy regimens, namely conjugated equine estrogens (CEE), CEE plus medroxyprogesterone acetate (MPA), tibolone, and raloxifene on cerebral blood flow and cognitive functions.


METHODS
A total of 64 healthy postmenopausal women admitted to the Department of Obstetrics and Gynecology, Cumhuriyet University, Turkey were included in this study. Patients were divided into five groups with respect to the treatment protocols: CEE 0.625 mg/day (n=13); CEE 0.625 mg/day + MPA 2.5 mg/day (n=14); tibolone 2.5 mg/day (n=11); raloxifene 60 mg/day (n=9); and control (n=17). The CEE group included only women with surgical menopause. Those who were on hormonal therapy, who had previously used hormonal therapy, who had neurological disorders, or who did not accept the longterm follow-up were excluded from the study. Demographic and clinic characteristics were recorded. Before starting the therapy regimens, cerebral blood flow was evaluated by internal carotid artery and middle cerebral artery peak systolic velocity, and pulsatility index measurements via Doppler ultrasonography. Cognitive functions were evaluated by the Standardized Mini-Mental Test. The mean follow-up period was 10.9+/-2.4 months, ranging between 8 and 16 months. After the follow-up period, the cerebral blood flow, and cognitive function of each woman was re-evaluated.


RESULTS
Demographic and clinical characteristics of the women were not significantly different between the study groups (P>0.05). There were no significant differences between the pretreatment and posttreatment values for cerebral blood flow indices and cognitive function scores in any of the study groups (P>0.05).


CONCLUSIONS
Different postmenopausal hormone therapy regimens have not revealed any significant effects on either cerebral blood flow or cognitive function.
Guvenal
Tevfik
T
Department of Obstetrics and Gynecology, Celal Bayar University Faculty of Medicine, Kadin Hastaliklari ve Dogum Anabilim Dali, Manisa, Turkey. tguvenal@yahoo.com
Durna
Aysenur
A
Erden
Omur
O
Guvenal
Feray
F
Cetin
Meral
M
Cetin
Ali
A
D000328:Adult; D000704:Analysis of Variance; D001783:Blood Flow Velocity / Q000187:drug effects; D002560:Cerebrovascular Circulation / Q000187:drug effects*; D016009:Chi-Square Distribution; D003071:Cognition / Q000187:drug effects*; D020847:Estrogen Receptor Modulators / Q000494:pharmacology; D015914:Estrogen Replacement Therapy / Q000379:methods*; D004966:Estrogens, Conjugated (USP) / Q000494:pharmacology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000494:pharmacology; D008609:Mental Status Schedule; D008875:Middle Aged; D009652:Norpregnenes / Q000494:pharmacology; D017698:Postmenopause / Q000187:drug effects*; D020849:Raloxifene Hydrochloride / Q000494:pharmacology; D014421:Turkey; D017585:Ultrasonography, Doppler, Transcranial
D020847:Estrogen Receptor Modulators; D004966:Estrogens, Conjugated (USP); D009652:Norpregnenes; D020849:Raloxifene Hydrochloride; D017258:Medroxyprogesterone Acetate; C027385:tibolone