title: Differential effects of estrogen and micronized progesterone or medroxyprogesterone acetate on cognition in postmenopausal women.
abstract: OBJECTIVE
  To investigate possible differential effects of the coadministration of conjugated equine estrogen (CEE) and a placebo (CEE + PL), CEE and medroxyprogesterone acetate (CEE + MPA), or CEE and micronized P (CEE + MP) on aspects of cognitive functioning in naturally postmenopausal women.
  
  
  METHODS
  Double-blind, randomized, controlled trial.
  
  
  METHODS
  Gynecologic screening occurred at a university hospital, and neuropsychological testing took place in a university laboratory.
  
  
  METHODS
  Twenty-four naturally menopausal women with an intact uterus who had never used hormone therapy were recruited by means of newspaper advertisements. All completed the study.
  
  
  METHODS
  A battery of mood and neuropsychological tests was administered. Women were randomly assigned to receive CEE + PL (n = 7), CEE + MPA (n = 9), or CEE + MP (n = 8). The tests were readministered 12 weeks later.
  
  
  METHODS
  Standardized tests of mood, verbal memory, working memory, spatial abilities, and visual-spatial sequencing, and assays of serum sex hormone levels.
  
  
  RESULTS
  Mood improved after treatment in all groups. No changes in scores occurred over time in any cognitive test in the group that received CEE + PL. Only the CEE + MP group had a significant decrease in their delayed verbal memory scores from baseline to after treatment. The CEE + MP-treated women performed significantly better on a test of working memory than women in the other two groups.
  
  
  CONCLUSIONS
  Coadministration of CEE with MPA or MP caused differential effects on aspects of memory in postmenopausal women. These findings need to be replicated with a larger sample size before their potential clinical implications can be determined.
authors.affiliation: Department of Psychology, McGill University, Montreal, Quebec, Canada. barbara.sherwin@mcgill.ca
authors.forename: Barbara B
authors.initials: BB
authors.lastname: Sherwin
authors.forename: Miglena
authors.initials: M
authors.lastname: Grigorova
mesh_terms: D000339:Affect / Q000187:drug effects; D000704:Analysis of Variance; D003071:Cognition / Q000187:drug effects*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D015914:Estrogen Replacement Therapy; D004966:Estrogens, Conjugated (USP) / Q000008:administration & dosage*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage*; D008568:Memory / Q000187:drug effects; D008875:Middle Aged; D009483:Neuropsychological Tests; D017698:Postmenopause; D011374:Progesterone / Q000008:administration & dosage*; D011792:Quebec; D013997:Time Factors
chemical_list: D004966:Estrogens, Conjugated (USP); D011374:Progesterone; D017258:Medroxyprogesterone Acetate