Estrogen Each Day May Keep Low Mood, Poor Memory Away
March 8, 2000 (New York) -- The female hormone estrogen may affect women's
moods and preserve their mental abilities as they age. In a review article in
the February issue of Psychiatric Annals, researchers say that though
the data are not conclusive, recent studies have shown that estrogen also may
improve depressed women's response to some antidepressant medications and
decrease the risk of dementia and Alzheimer's disease.
Estrogen has been shown to prevent both heart disease and the bone-thinning
disease osteoporosis in women after menopause. Some studies also have found
that estrogen alone, given as estrogen replacement therapy (ERT), and estrogen
combined with the male hormone testosterone, improve mood and symptoms of
depression, such as tearfulness and emotional numbness. But other studies have
shown no clear difference between estrogen and a placebo (sugar pill) in
depressed postmenopausal women.
"I think there is a group of postmenopausal women who do have
antidepressant responses to estrogen, and there may be other reasons why
estrogen is good for them as well, but we haven't figured out how to identify
them," Mary F. Morrison, MD, author of the review article, tells WebMD.
Morrison, who is an assistant professor of psychiatry and medicine at the
University of Pennsylvania School of Medicine in Philadelphia, says it is not
yet clear exactly how estrogen works to alter mood.
Progestin, another hormone that is often given in combination with estrogen
as hormone replacement therapy after menopause, has not been as extensively
studied for its effect on mood, but at least one study did find much smaller
reductions in depressed mood in women taking progestin alone or in combination
with estrogen, compared with those taking estrogen alone.
Some studies also have suggested that estrogen may improve response to a
group of commonly used antidepressants called selective serotonin reuptake
inhibitors (SSRIs). A study by Gary Small, MD, professor of psychiatry and
biobehavioral sciences at the UCLA, found that elderly depressed women on ERT
had a nearly three times better chance of responding to Prozac, which is an
SSRI, compared with those taking a placebo. Small tells WebMD that he and
co-author Lon Schneider, MD, also of UCLA, have submitted another article for
publication showing similar results using Zoloft, another SSRI.
"It's not clear what is causing this," Small says. "Estrogen has
a lot of effects on the brain, and it certainly modulates [serotonin] function,
so it could have something to do with that. But there could be some other
factors related to these women that has nothing to do with estrogen."
Research also has suggested that ERT may prevent, or at least decrease the
risk of, Alzheimer's disease. The National Institute on Aging is currently
enrolling postmenopausal women in a three-year study to determine if estrogen
therapy can prevent Alzheimer's in women with a family history of the disease.
Physicians and patients can get more information on this trial, known as
PREPARE, by visiting the institute's web site (www.delay-ad.org) or calling (877)
Estrogen is also being studied in women with established Alzheimer's
dementia. Two trials showed mental improvements among women with dementia who
were taking ERT. But a recent study in the Feb. 23 issue of the Journal of
the American Medical Association found no significant changes between the
group of elderly women with mild to moderate Alzheimer's disease that took the
drug and those who did not.