POSTMENOPAUSE
EFFECT OF OESTROGEN ON BRAIN ACTIVATION PATTERNS IN POSTMENOPAUSAL
WOMEN DURING WORKING MEMORY TASKS
Declining oestrogen levels characterise menopause with
effects on a range of systems including, in addition to
the reproductive system, the cardiovascular and skeletal
systems. Furthermore, there is evidence that oestrogen affects
basic neural processes. Therefore, a study was carried out
to investigate the effects of oestrogen on brain activation
patterns in post-menopausal women as they performed verbal
and non-verbal working memory tasks.
The study group consisted of 46 post-menopausal women aged
33 to 61 years. The trial consisted of a 21-day treatment
with conjugated equine oestrogens, 1.25 mg/d, randomly crossed
over with identical placebo and a 14-day washout between
treatments. Brain activation patterns were measured using
functional magnetic resonance imaging during tasks involving
verbal and non-verbal working memory. It was found that
treatment with oestrogen increased activation in the inferior
parietal lobule during storage of verbal material and decreased
activation in the inferior parietal lobule during storage
of non-verbal material. Oestrogen also increased activation
in the right frontal gyrus during retrieval tasks, accompanied
by greater left-hemisphere activation during encoding. Oestrogen
did not affect actual performance of the verbal and non-verbal
memory tasks.
Thus, oestrogen in a therapeutic dosage alters brain activation
patterns in post-menopausal women in specific brain regions
during the performance of the sorts of memory function that
are called upon frequently during any given day. These results
suggest that oestrogen affects brain organisation for memory
in post-menopausal women.
Shaywitz, S.E. et al
J.A.M.A. 1999, 281 (13) 1197-1202
SOYA REDUCES HOT FLUSHES
A group of 104 women who were having at least 7 hot flushes
daily were given 60g soya daily. After 3 weeks they were
having 26% fewer flushes, and after 3 months it was 45%
fewer compared to 30% in women taking a placebo.
Albertazzi, P. et al
OBST. & GYNEC. 1998, 91 (1) 6-11
Courtesy AMER. HERB ASSOC. NEWS. 1998, XIV (3)
VITAMIN E REDUCES HOT FLUSHES
120 breast cancer survivors, who were going through the
menopause and were advised not to take HRT, were given 800
IU vitamin E daily for one month, then a placebo for another
month. The women had fewer hot flushes when taking vitamin
E.
Berton D.L. et al,
J. CLIN. ONCOLOGY 1998, 16, 495-500
Courtesy AMER. HERB ASSOC. NEWS. 1998, XIV (3)
MORE EFFORT NEEDED TO HALT OSTEOPOROTIC BONE LOSS
At a recent British Society for Rheumatology meeting it
was announced that steroid-induced osteoporosis is a problem
that is not being effectively tackled. About 0.5% of the
general population is receiving long-term steroid therapy,
but a survey showed that only about 14% had taken some form
of preventative treatment for bone loss. It was reported
that the C-terminal (CTX) and N-terminal (NTX) peptides
of type-1 collagen were helpful biochemical markers for
prediction of bone loss in osteoporosis. CTX and free deoxypyridinoline
have also proved highly predictive of hip-fracture rate
in osteoporosis, independent of bone mass. It was suggested
that patients on prednisolone 7.5 mg or more per day for
6 months or longer should be targeted for prophylactic therapy
for bone loss. Vitamin D and calcium supplementation should
be considered in all patients.
Clark, S.
LANCET 1998, 351 (9112) 1335
OESTROGEN THERAPY IN POSTMENOPAUSAL WOMEN - EFFECTS ON
COGNITIVE FUNCTION AND DEMENTIA
Researchers carried out a literature search of studies
published from January 1996 to June 1997 to determine whether
postmenopausal oestrogen therapy improves cognition, prevents
development of dementia, or improves dementia severity.
Biochemical and neurophysiologic studies suggest several
mechanisms by which oestrogen may affect cognition: promotion
of cholinergic and serotonergic activity in specific brain
regions, maintenance of neural circuitry, favourable lipoprotein
alterations, and prevention of cerebral ischaemia. In trials
assessing the effects of oestrogen on cognitive function
cognition seems to improve in perimenopausal women, possibly
because menopausal symptoms improve, but there is no clear
benefit in asymptomatic women. Meta-analysis of studies
concerning the effects of postmenopausal oestrogen use on
the risk of developing dementia suggests a 29% decreased
risk among oestrogen users, but the findings of the study
are heterogeneous. Large placebo-controlled trials are required
to address oestrogen’s role in prevention and treatment
of Alzheimer disease and other dementias.
The researchers conclude that, given the known risks of
oestrogen therapy, it is not recommended that oestrogen
be given for the prevention or treatment of Alzheimer disease
or other dementias until adequate trials have been completed.
Yaffe, K. et al
J.A.M.A. 1998, 279 (9) 688-95
THE EFFECT OF DIETARY SOY SUPPLEMENTATION ON HOT FLUSHES
A double-blind, parallel, randomised placebo-controlled
trial of 104 postmenopausal women was carried out to assess
the effect of daily dietary supplementation of soy protein
isolate powder on hot flushes. Fifty-one patients took 60
g of isolated soy protein daily and 53 patients took 60
g of placebo (casein) for 12 weeks.
Soy was significantly superior to placebo in reducing the
mean number of hot flushes per 24 hours. In particular,women
taking soy had a 26% reduction in the mean number of hot
flushes by week 3 and a 33% reduction by week 4. By the
end of the 12th week, patients taking soy had a 45% reduction
in their daily hot flushes compared with a 30% reduction
obtained with the placebo. Gastrointestinal side effects
were the most common cause of premature withdrawal from
the study (seven patients in each group).
Albertazzi, P. et al.
OBSTET. GYNECOL. 1998, 91 6-11
