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Chapter 9 - Memory and Mood in the Menopause

Published online by Cambridge University Press:  18 June 2020

Nicholas Panay
Affiliation:
Queen Charlotte's & Chelsea Hospital, London
Paula Briggs
Affiliation:
Liverpool Women's NHS Foundation Trust
Gabor T. Kovacs
Affiliation:
Monash University, Victoria
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Summary

Previous studies have reported that the menopause is associated with deterioration in memory and mood in some women. Also, a significant body of research suggests that hormone ‘replacement’ therapy (HRT) – now referred to as menopausal hormone therapy (MHT) – specifically with estrogen, may act as a prophylaxis against the risk for developing Alzheimer’s disease (AD) and a treatment for perimenopausal depression. The precise nature, and biological basis, of this relationship is still not fully understood. However, it probably involves a complex interaction between genes, the environment and the mode and timing of MHT prescription. Increasing our understanding of the interplay between these factors during the menopause may permit us to target more specific treatments to vulnerable individuals. Furthermore, it offers a window of opportunity to understand the putative role of estrogen in psychiatric disorders at other times of the reproductive cycle. The current chapter will focus on the role of estrogen on Alzheimer’s disease and depression during the menopause.

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Publisher: Cambridge University Press
Print publication year: 2020

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References

Evans, D, Ganguli, M, Harris, T, Kawas, C, Larson, EB. Women and Alzheimer disease. Alzheimer Dis Assoc Disord 1999;13:187–9.CrossRefGoogle ScholarPubMed
Lopez, OL, Jagust, WJ, DeKosky, ST, et al. Prevalence and classification of mild cognitive impairment in the Cardiovascular Health Study Cognition Study: part 1. Arch Neurol 2003;60:1385–9.Google ScholarPubMed
McCrone, P, Dhanasiri, S, Patel, A, Knapp, M, Lawton-Smith, S. Paying the Price: The Cost of Mental Health Care in England to 2026. 2008. King’s Fund.Google Scholar
Zandi, PP, Carlson, MC, Plassman, BL, et al. Hormone replacement therapy and incidence of Alzheimer disease in older women: the Cache County Study. JAMA 2002;288:2123–9.Google Scholar
Comas-Herrera, A, Wittenberg, R, Pickard, L, Knapp, M. Cognitive impairment in older people: future demand for long-term care services and the associated costs. Int J Geriatr Psychiatry 2007;22:1037–45.CrossRefGoogle ScholarPubMed
Rocca, WA, Bower, JH, Maraganore, DM, et al. Increased risk of cognitive impairment or dementia in women who underwent oophorectomy before menopause. Neurology 2007;69:1074–83.CrossRefGoogle ScholarPubMed
LeBlanc, ES, Janowsky, J, Chan, BKS, Nelson, HD. Hormone replacement therapy and cognition: systematic review and meta-analysis. JAMA 2001;285:1489–99.Google ScholarPubMed
Maki, PM, Sundermann, E. Hormone therapy and cognitive function. Hum Reprod Update 2009;15:667–81.Google Scholar
Shumaker, SA, Legault, C, Rapp, SR, et al. Estrogen plus progestin and the incidence of dementia and mild cognitive impairment in postmenopausal women: the Women’s Health Initiative Memory Study: a randomized controlled trial. JAMA 2003;289:2651–62.Google Scholar
Savolainen-Peltonen, H, Rahkola-Soisalo, P, Hoti, F, et al. Use of postmenopausal hormone therapy and risk of Alzheimer’s disease in Finland: nationwide case-control study. BMJ 2019;364:1665.Google ScholarPubMed
Schmid, NS, Taylor, KI, Foldi, NS, Berres, M, Monsch, AU. Neuropsychological signs of Alzheimer’s disease 8 years prior to diagnosis. J Alzheimer’s Dis 2013;34:537–46.Google ScholarPubMed
Gleason, CE, Dowling, NM, Wharton, W, et al. Effects of hormone therapy on cognition and mood in recently postmenopausal women: findings from the randomized, controlled KEEPS-Cognitive and Affective Study. PLoS Med 2015;12(6):e1001833.CrossRefGoogle Scholar
Henderson, VW, St John, JA, Hodis, HN, et al. Cognitive effects of estradiol after menopause: a randomized trial of the timing hypothesis. Neurology 2016;87(7):699708.CrossRefGoogle ScholarPubMed
Maki, P. Menopausal hormone therapy and cognition. BMJ 2019;364:1877.Google Scholar
World Health Organization. World Health Report: Shaping the Future. 2003. WHO.Google Scholar
Wassertheil-Smoller, S, Shumaker, S, Ockene, J, et al. The Women’s Health Initiative (WHI) – depression and cardiovascular sequelae in postmenopausal women. Arch Intern Med 2004;164(3):289–98.CrossRefGoogle ScholarPubMed
Stewart, DE, Boydell, KM. Psychologic distress during menopause: associations across the reproductive life cycle. Int J Psychiatr Med 1993;23:157–62.CrossRefGoogle ScholarPubMed
Gregory, RJ, Masand, PS, Yohai, NH. Depression across the reproductive life cycle: correlations between events. Prim Care Companion J Clin Psychiatry 2000;2:127–9.Google Scholar
Payne, JL, Roy, PS, Murphy-Eberenz, K, et al. Reproductive cycle-associated mood symptoms in women with major depression and bipolar disorder. J Affect Disord 2007;99:221–9.Google Scholar
Chuong, CJ, Burgos, DM. Medical history in women with premenstrual syndrome. J Psychosom Obstet Gynaecol 1995;16:21–7.CrossRefGoogle ScholarPubMed
Morse, CA, Dudley, E, Guthrie, J, Dennerstein, L. Relationships between premenstrual complaints and perimenopausal experiences. J Psychosom Obstet Gynaecol 1998;19:182–91.Google Scholar
Binfa, L, Castelo-Branco, C, Blumel, JE, et al. Influence of psycho-social factors on climacteric symptoms. Maturitas 2004;48:425–31.Google Scholar
Freeman, EW, Sammel, MD, Liu, L, et al. Hormones and menopausal status as predictors of depression in women in transition to menopause. Arch Gen Psychiat 2004;61:6270.Google Scholar
Aydin, N, Inandi, T, Karabulut, N. Depression and associated factors among women within their first postnatal year in Erzurum province in eastern Turkey. Women Health 2005;41:112.Google Scholar
Bloch, M, Rotenberg, N, Koren, D, Klein, E. Risk factors associated with the development of postpartum mood disorders. J Affect Disord 2005;88:918.Google Scholar
Bloch, M, Rotenberg, N, Koren, D, Klein, E. Risk factors for early postpartum depressive symptoms. Gen Hosp Psychiatr 2006;28:38.Google Scholar
Gordon, JL, Rubinow, DR, Eisenlohr-Moul, TA, Xia, K, Schmidt, PJ, Girdler, SS. Efficacy of transdermal estradiol and micronized progesterone in the prevention of depressive symptoms in the menopause transition: a randomized clinical trial. JAMA Psychiatr 2018;75(2):149–57.Google Scholar
Schmidt, PJ, Nieman, L, Danaceau, MA, et al. Estrogen replacement in perimenopause-related depression: a preliminary report. Am J Obstet Gynecol 2000;183:414–20.Google Scholar
Soares, CN, Almeida, OP, Joffe, H, Cohen, LS. Efficacy of estradiol for the treatment of depressive disorders in perimenopausal women: a double-blind, randomized, placebo-controlled trial. Arch Gen Psychiatr 2001;58:529–34.Google ScholarPubMed
Studd, J, Panay, N. Are oestrogens useful for the treatment of depression in women? Best Pract Res Clin Obstet Gynaecol 2009;23:6371.Google Scholar
Studd, J. Ten reasons to be happy about hormone replacement therapy: a guide for patients. Menopause Int 2010;16:44–6.CrossRefGoogle ScholarPubMed
Studd, J. Why are estrogens rarely used for the treatment of depression in women? Gynecol Endocrinol 2007;23:63–4.CrossRefGoogle ScholarPubMed
Studd, J, Panay, N. Hormones and depression in women. Climacteric 2004;7:338–46.Google Scholar
Studd, JWW. A guide to the treatment of depression in women by estrogens. Climacteric 2011;14:637–42.Google Scholar
McEwen, B. Estrogen actions throughout the brain. Recent Prog Horm Res 2002;57:357–84.CrossRefGoogle ScholarPubMed
Kenealy, BP, Kapoor, A, Guerriero, KA, et al. Neuroestradiol in the hypothalamus contributes to the regulation of gonadotropin releasing hormone release. J Neurosci 2013;33:19051–9.CrossRefGoogle Scholar
Heldring, N, Pike, A, Andersson, S, et al. Estrogen receptors: how do they signal and what are their targets. Physiol Rev 2007;87:905–31.CrossRefGoogle ScholarPubMed
Craig, MC, Cutter, WJ, van Amelsvoort, TAMJ, Rymer, J, Whitehead, M, Murphy, DGM. Effects of estrogen replacement therapy on dopaminergic responsivity in postmenopausal women. Biol Psychiatr 2003;53:210S.Google Scholar
Craig, MC, Fletcher, PC, Daly, EM, et al. The interactive effect of the cholinergic system and acute ovarian suppression on the brain: an fMRI study. Horm Behav 2009;55:41–9.Google Scholar
Davies, P, Maloney, AJ. Selective loss of central cholinergic neurons in Alzheimer’s disease. Lancet 1976;2:1403.Google Scholar
Bowen, DM, Smith, CB, White, P, Davison, AN. Neurotransmitter-related enzymes and indices of hypoxia in senile dementia and other abiotrophies. Brain 1976;99:459–96.CrossRefGoogle ScholarPubMed
Shytle, RD, Silver, AA, Lukas, RJ, et al. Nicotinic acetylcholine receptors as targets for antidepressants. Mol Psychiatr 2002;7:525–35.Google Scholar
van Amelsvoort, TAMJ, Abel, KM, Robertson, DMR, et al. Prolactin response to d-fenfluramine in postmenopausal women on and off ERT: comparison with young women. Psychoneuroendocrinology 2001;26:494502.Google Scholar
Dunlop, BW, Nemeroff, CB. The role of dopamine in the pathophysiology of depression. Arch Gen Psychiatr 2007;64:327–37.Google Scholar
Backman, L, Nyberg, L. Dopamine and training-related working-memory improvement. Neurosci Biobehav Rev 2013;37:2209–19.Google Scholar
Ettigi, P, Lal, S, Martin, JB, Friesen, HC. Effects of sex, oral contraceptives, and glucose loading on apomorphine induced growth hormone secretion. J Clin Endocrinol Metab 1975;40:1094–8.Google Scholar
Wieck, A, Hirst, AD, Kumar, R, Checkley, SA, Campbell, IC. Growth hormone secretion by human females in response to apomorphine challenge is markedly affected by menstrual cycle phase. B J Clin Pharmacol 1989;27:700–1.Google Scholar
Wieck, A, Kumar, R, Marks, MN, Checkley, SA. Increased sensitivity of dopamine receptors and recurrence of affective psychosis after childbirth. Br Med J (Clin Res Ed) 1991;303:613–16.CrossRefGoogle ScholarPubMed
Craig, M, Cutter, W, Wickhham, H, van Amelsvoort, T, Murphy, D. Effect of long-term estrogen therapy on dopaminergic responsivity in postmenopausal women. Psychoneuroendocrinology 2004;29:1309–16.CrossRefGoogle Scholar
Lamar, M, Craig, M, Daly, EM, et al. Acute tryptophan depletion promotes an anterior-to-posterior fMRI activation shift during task switching in older adults. Hum Brain Mapp 2014;35:712–22.CrossRefGoogle ScholarPubMed
Halbreich, U, Rojansky, N, Palter, S, et al. Estrogen augments serotonergic activity in postmenopausal women. Biol Psychiatr 1995;37:434–41.Google Scholar
Matthews, KA, Kuller, LH, Wing, RR, Meilahn, EN, Plantinga, P. Prior to use of estrogen replacement therapy, are users healthier than nonusers? Am J Epidemiol 1996;143:971–8.Google Scholar
Resnick, SM, Maki, PM, Golski, S, Kraut, MA, Zonderman, AB. Effects of estrogen replacement therapy on PET cerebral blood flow and neuropsychological performance. Horm Behav 1998;34:171–82.CrossRefGoogle ScholarPubMed
Raz, N, Gunning-Dixon, F, Head, D, et al. Aging, sexual dimorphism, and hemispheric asymmetry of the cerebral cortex: replicability of regional differences in volume. Neurobiol Aging 2004;25:377–96.Google Scholar
Eberling, JL, Wu, C, Tong-Turnbeaugh, R, Jagurst, J. Estrogen-and-tamoxifen-associated effects on brain structure and function. Neuroimage 2004;21:364–71.Google Scholar
Erickson, KI, Colcombe, SJ, Raz, N, et al. Selective sparing of brain tissue in postmenopausal women receiving hormone replacement therapy. Neurobiol Aging 2005;26:1205–13.Google Scholar
Robertson, DMW, Craig, MC, Van Amelsvoort, T, et al. Effects of estrogen replacement therapy on age-related differences in grey matter volume. Climacteric 2009;12:301–9.Google Scholar
Eberling, JL, Wu, C, Mungas, D, Buoncore, M, Jagurst, J. Preliminary evidence that oestrogen protects against age-related hippocampal atrophy. Neurobiol Aging 2003;24:725–32.CrossRefGoogle ScholarPubMed
McEwen, BS. Glucocorticoids, depression, and mood disorders: structural remodeling in the brain. Metabolism 2005;54 Suppl 1:20–3.Google Scholar
Robertson, D, Craig, MC, van Amelsvoort, T, et al. Effects of estrogen therapy on age-related differences in gray matter concentration. Climacteric 2009;12:301–9.Google Scholar
Schmidt, R, Fazekas, F, Reinhart, B, et al. Estrogen replacement therapy in older women: a neuropsychological and brain MRI study. J Am Geriatr Soc 1996;44:1307–13.Google Scholar
Cook, IA, Morgan, ML, Dunkin, JJ, et al. Estrogen replacement therapy is associated with less progression of subclinical structural brain disease in normal elderly women: a pilot study. Int J Geriatr Psychiatry 2002;17:610–18.CrossRefGoogle ScholarPubMed
Raz, E, Tighe, H, Sato, Y, et al. Preferential induction of a Th1 immune response and inhibition of specific IgE antibody formation by plasmid DNA immunization. Proc Natl Acad Sci USA 1996;93:5141–5.Google Scholar
Jernigan, TL, Archibald, SL, Fennema-Notestine, C, et al. Effects of age on tissues and regions of the cerebrum and cerebellum. Neurobiol Aging 2001;22:581–94.CrossRefGoogle ScholarPubMed
Sullivan, EV, Marsh, L, Mathalon, DH, Lim, KO, Pfefferbaum, A. Age-related decline in MRI volumes of temporal lobe gray matter but not hippocampus. Neurobiol Aging 1995;16:591606.Google Scholar
Sherwin, BB, Henrya, JF. Brain aging modulates the neuroprotective effects of estrogen on selective aspects of cognition in women: a critical review. Frontiers Neuroendocrinol 2008;29:88113.Google Scholar
Eberling, JL, Reed, BR, Coleman, JE, Jagust, WJ. Effect of estrogen on cerebral glucose metabolism in postmenopausal women. Neurology 2000;55:875–7.CrossRefGoogle ScholarPubMed
Shaywitz, SE, Shaywitz, BA, Pugh, KR, et al. Effect of estrogen on brain activation patterns in postmenopausal women during working memory tasks. JAMA 1999;281:1197–202.Google Scholar
Berman, KF, Schmidt, PJ, Rubinow, DR, et al. Modulation of cognition-specific cortical activity by gonadal steroids: a positron-emission tomography study in women. Proc Natl Acad Sci USA 1997;94:8836–41.CrossRefGoogle ScholarPubMed
Craig, MC, Fletcher, PC, Daly, EM, et al. Gonadotropin hormone releasing hormone agonists alter prefrontal function during verbal encoding in young women. Psychoneuroendocrinology 2007;32:1116–27.Google Scholar
Craig, MC, Fletcher, PC, Daly, EM, et al. Reversibility of the effects of acute ovarian hormone suppression on verbal memory and prefrontal function in pre-menopausal women. Psychoneuroendocrinology 2008;33:1426–31.Google Scholar
Craig, MC, Brammer, M, Maki, PM, et al. The interactive effect of acute ovarian suppression and the cholinergic system on visuospatial working memory in young women. Psychoneuroendocrinology 2010;35:9871000.CrossRefGoogle ScholarPubMed
Jenden, DJ. The metabolism of choline. Bull Clin Sci 1990;55:99106.Google Scholar
Pfefferbaum, A, Adalsteinsson, E, Speilman, D, Sullivan, EV, Lim, KO. In vivo spectroscopic quantification of the N-acetyl-moiety, creatine, and choline from large volume of brain grey and white matter: the effects of normal aging. Magn Reson Med 1999;41:276–84.3.0.CO;2-8>CrossRefGoogle ScholarPubMed
Robertson, DM, van Amelsvoort, T, Daly, E, et al. Effects of estrogen replacement therapy on human brain aging: an in vivo 1H MRS study. Neurology 2001;57:2114–17.Google Scholar
Ernst, T, Chang, L, Cooray, D, et al. The effects of tamoxifen and estrogen on brain metabolism in elderly women. J Natl Cancer Inst 2002;94:592–7.Google Scholar
Chang, L, Ernst, T, Poland, RE, Jenden, DJ. In vivo proton magnetic resonance spectroscopy of the normal aging human brain. Life Sci 1996;58:2049–56.Google Scholar
Huang, W, Alexander, GE, Chang, L, et al. Brain metabolite concentration and dementia severity in Alzheimer’s disease: a 1H MRS study. Neurology 2001;57:626–32.CrossRefGoogle ScholarPubMed
Kugaya, A, Epperson, CN, Zoghbi, S, et al. Increase in prefrontal cortex serotonin 2 A receptors following estrogen treatment in postmenopausal women. Am J Psychiatry 2003;160:1522–4.Google Scholar
Moses, EL, Drevets, WC, Smith, G, et al. Effects of estradiol and progesterone administration on human serotonin 2 A receptor binding: a PET study. Biol Psychiatry 2000;48:854–60.Google Scholar
Compton, J, Travis, MJ, Norbury, R, et al. Long-term estrogen therapy and 5-HT2A receptor binding in postmenopausal women; a single photon emission tomography (SPET) study. Horm Behav 2008;53:61–8.Google Scholar
Nobury, R, Travis, MJ, Erlandsson, K, et al. Estrogen therapy and brain muscarinic receptor density in healthy females: a SPET study. Horm Behav 2007;51:249–57.Google Scholar
Smith, YR, Minoshima, S, Kuhl, DE, Zubieta, JK. Effects of long-term hormone therapy on cholinergic synaptic concentrations in healthy postmenopausal women. J Clin Endocrinol Metab 2001;86:679–84.Google Scholar
Nobury, R, Travis, MJ, Erlandsson, K, et al. In vivo imaging of muscarinic receptors in the aging female brain with (R,R)[123I]-I-QNB and single photon emission tomography. Exp Gerontol 2005;40:137–45.Google Scholar

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