In their paper “Perimenopausal use of hormone therapy is associated with enhanced memory and hippocampal function later in life” Pauline M. Maki et al. examined a phenomenon they termed the “critical window hypothesis”, which suggests that hormone therapy (HT) in the perimenopausal (during menopause) state can be beneficial to long-term cognition, whereas hormone therapy during the postmenopausal period shows neither beneficial nor harmful effects (Maki et al., 2011). The researchers were interested in examining patterns of brain activation in the medial temporal lobe, which they hypothesized might play a role in verbal encoding and word recognition. They found that subjects who were given perimenopausal hormone therapy scored better than their perimenopausal non-HT counterparts in both areas and identified that their results were consistent with the “critical window hypothesis” (Maki et al., 2011).
In addition to perimenopausal HT, the long-term premenopausal usage of another form of hormone intervention, hormonal contraceptive usage, was hypothesized to have a positive, duration-dependent effect on long-term cognitive function (Egan et al., 2012). It was found that women who utilized hormonal contraceptives showed significantly better performance in both visuo-spatial ability and speed & flexibility compared to matched “never users” who did not take hormonal contraceptives (Egan et al., 2012). Not only was this association determined, but there was also a dose-dependent aspect to this conclusion in which the longer a subject took hormonal contraceptives, the better their cognitive scores were in the aforementioned areas, especially in subjects with fifteen or more years of use (Egan et al., 2012).
Together, these two studies show the benefits of different hormone interventions on later-year cognition. Notably, these interventions showed benefits after use during different times in the menopausal timeline, with hormonal contraception showing benefits after long-term premenopausal usage and hormone therapy showing cognitive improvements during the perimenopausal window (aligning with the “critical window hypothesis”). This shows that the potential for hormone effects on cognitive health is vast and has promising applications at any point in the reproductive lifespan, and highlights an interesting link between reproductive, endocrine, and neural health.
References:
Egan, K. R., & Gleason, C. E. (2012). Longer duration of hormonal contraceptive use predicts
better cognitive outcomes later in life. Journal of women's health (2002), 21(12), 1259
Maki, P. M., Dennerstein, L., Clark, M., Guthrie, J., LaMontagne, P., Fornelli, D., Little, D.,
Henderson, V. W., & Resnick, S. M. (2011). Perimenopausal use of hormone therapy is
associated with enhanced memory and hippocampal function later in life. Brain
research, 1379, 232–243. https://doi.org/10.1016/j.brainres.2010.11.030
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