title: Estrogen treatment impairs cognitive performance after psychosocial stress and monoamine depletion in postmenopausal women.
abstract: OBJECTIVE
  Recent studies have shown that women experience an acceleration of cognitive problems after menopause and that estrogen treatment can improve or at least maintain current levels of cognitive functioning in postmenopausal women. However, we have previously shown that the negative emotional effects of psychosocial stress are magnified in normal postmenopausal women after estrogen treatment. This study examined whether estradiol (E2) administration can modify cognitive performance after exposure to psychological stress and monoamine depletion.
  
  
  METHODS
  Participants consisted of 22 postmenopausal women placed on either oral placebo or 17beta-E2 (1 mg/d for 1 mo, then 2 mg/d for 2 mo). At the end of the 3-month treatment phase, participants underwent three depletion challenges in which they ingested one of three amino acid mixtures: deficient in tryptophan, deficient in phenylalanine/tyrosine, or balanced. Five hours later, participants performed the Trier Social Stress Test (TSST), followed by mood and anxiety ratings and cognitive testing. Cognitive measures included tests of attention, psychomotor function, and verbal episodic memory.
  
  
  RESULTS
  E2-treated compared with placebo-treated participants exhibited significant worsening of cognitive performance on tasks measuring attentional performance and psychomotor speed. Similar trends for impairment were seen in measures of long-term episodic memory compared with placebo-treated postmenopausal women. E2-treated participants also showed a significant increase in negative mood and anxiety compared with placebo-treated women after, but not before, the TSST, although the worsening of both cognitive and behavioral functioning was not correlated. These effects were independent of tryptophan or tyrosine/phenylalanine depletion and were not manifested before the TSST or at baseline.
  
  
  CONCLUSIONS
  These data suggest that the relationship between estrogen administration and cognitive/behavioral performance in postmenopausal women may be more complex than initially appreciated and that the effects of psychosocial stress may influence whether hormone effects are beneficial.
authors.affiliation: Department of Psychiatry, University of Vermont College of Medicine, Burlington, VT, USA. Paul.Newhouse@uvm.edu
authors.forename: Paul A
authors.initials: PA
authors.lastname: Newhouse
authors.forename: Julie
authors.initials: J
authors.lastname: Dumas
authors.forename: Heather
authors.initials: H
authors.lastname: Wilkins
authors.forename: Emily
authors.initials: E
authors.lastname: Coderre
authors.forename: Cynthia K
authors.initials: CK
authors.lastname: Sites
authors.forename: Magdalena
authors.initials: M
authors.lastname: Naylor
authors.forename: Chawki
authors.initials: C
authors.lastname: Benkelfat
authors.forename: Simon N
authors.initials: SN
authors.lastname: Young
mesh_terms: D000339:Affect / Q000502:physiology; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000503:physiopathology; D003072:Cognition Disorders / Q000503:physiopathology*; D004311:Double-Blind Method; D004958:Estradiol / Q000097:blood / Q000494:pharmacology*; D004967:Estrogens / Q000494:pharmacology*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D011939:Mental Recall / Q000502:physiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D010649:Phenylalanine / Q000097:blood / Q000172:deficiency; D017698:Postmenopause / Q000502:physiology; D013315:Stress, Psychological / Q000503:physiopathology*; D014364:Tryptophan / Q000097:blood / Q000172:deficiency; D014443:Tyrosine / Q000097:blood / Q000172:deficiency
chemical_list: D004967:Estrogens; D014443:Tyrosine; D010649:Phenylalanine; D004958:Estradiol; D014364:Tryptophan; D005640:Follicle Stimulating Hormone; D006854:Hydrocortisone