A review of the impact of hormone therapy on prefrontal structure and function at menopause

Abstract

The menopause transition arises mainly from a decline in ovarian function characterized by a decrease in levels of ovarian estrogens (estradiol) and progesterone in women. Menopausal hormone therapy (MHT) has been used to counteract menopause-associated symptoms in postmenopausal women. With the development of advanced brain imaging methods, understanding MHT-related effects on brain structures and functions could help advance our understanding of the biological consequence of MHT-related effects on behavior, thereby contributing to developing new strategies for optimizing brain health during the menopause transition. This review focuses on the human research related to the impact of MHT on structural and functional organization of the prefrontal cortex in postmenopausal women. Although such MHT-related effects on brain structures and functions have only begun to be understood, it may be useful to examine present findings to identify areas for future research.

Effect of Fennel Aromatherapy (Foeniculum Vulgare) On Decreasing Menopause Symptom Levels in Menopausal Women in Tunjung Village Bangkalan Regency Indonesia

“…It is supported by Y. Li and J. C. Dreher [8] That states that, it is estimated that at least 80% of postmenopausal women have experienced at least one symptom of menopause in a lifetime. F. Seyyedi [19] also mentioned that more than 80% of women experience symptoms both physical and psychological in the run-up to menopause with various stresses and disorders in life thus causing a decrease in the quality of life.These findings are also in line with the research of M.Dabrowska, et al, [20] which mentions that of the perimenopausal women studied almost half (43.04%) experienced severe levels of menopausal symptoms.…”

“…Although menopause is a natural phase of the female life cycle that occurs as part of aging in women can increase the risk of health problems [8]. Transitions in menopause involve a myriad of physical, endocrine, and psychological changes influenced by ethnic, psychological, and sociocultural factors [2].…”

Mind the Gap: Estrogen receptor beta (ERβ) in astrocytes is a therapeutic target to prevent cognitive problems at menopause.

“…While treatment with estradiol patch versus oral Premarin in early menopausal women aged 42-56 years showed no bene t of Premarin, estradiol treatment decreased regional gray matter atrophy in the dorsolateral prefrontal cortex and there was lower Pittsburgh compound B uptake in cortex during positron emission tomography (PET) imaging, albeit with no effect on whole brain volumes or global cognition 6,7 . An estrogen-speci c and timing-speci c in uence on structure and function of prefrontal cortex has also been shown by a promising effect of treatment with ethinyl estradiol, but not Premarin, if administered during early, but not late, menopause 14,51 . Lastly, cognitive complaints in menopausal women age 50 to 60 years have been correlated with lower gray matter volume in the right medial temporal lobe 52 .…”

Scientific insights into brain fog during the menopausal transition

“…A review by Kim and Brinton [14] makes the case for a personalized treatment approach that focuses on symptomatic women, and considers the duration and type of MHT, as well as genetic risk factors. Li and Dreher [15] review clinical neuroimaging studies showing beneficial effects of MHT on the structure and function of the prefrontal cortex in postmenopausal women. Hugenschmidt and colleagues [16] review evidence, including data from the Women's Health Initiative, suggesting that type 2 diabetes mellitus modifies the effects of MHT on brain function in older women, conferring reliable negative effects and suggesting a need for a personalized medicine approach that limits use of MHT in women with that condition.…”