The timing of estrogen therapy after ovariectomy--implications for neurocognitive function.

摘要

Removal of the ovaries and uterus before the natural onset of menopause results in acute declines in the circulating levels of the ovarian steroid hormones, estrogen and progesterone, as well as reduced testosterone levels. The effect of surgical menopause on cognitive function has been a topic of great clinical interest since 1988, when Barbara Sherwin published a randomized clinical trial demonstrating that women (mean age approx 45 years) who underwent surgical menopause experienced a decline in verbal memory from a premenopausal, presurgery baseline to a postsurgery follow-up 3 months later. Of particular interest, there was statistically significant cognitive benefit from treatment with 10 mg intramuscular estradiol valerate per month and/or an androgen immediately after surgery when compared with placebo.