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Estrogen and Cognitive Health

Evidence, accumulated over the past several decades, shows that estrogen plays a critical role in the modulation of cognitive function in animals and humans. Modulation begins in the womb when estrogens exert their effect on various brain regions involved in cognitive function. Estrogen influences the nervous system, and this continues through adulthood when its production reaches the highest levels. With aging, estrogen levels gradually decline and contribute to impairment in memory, learning, and thinking skills. Research in basic neuroscience and other clinical research shows that ERT protects against the age-related decline in cognitive function:
1. In postmenopausal women and women with Alzheimer’s disease (AD), ERT significantly improves memory and attention. [246]
2. In young surgically menopausal women, injection of 10 mg estradiol every month for 3 months improves verbal memory, abstract reasoning, speed and accuracy. [247]
3. In healthy postmenopausal women, ERT lowers the risk of Alzheimer’s disease by 29% to 34%. [248-250]
4. In patients with lesions in the frontal cortex of the brain, ERT use is associated with significant improvements in verbal memory. [251-254]
5. In patients with age-related cognitive decline, estrogen helps maintain cognitive functions mediated by the frontal lobes. [255-261]
6. In postmenopausal women, ERT enhances performance on certain tests of working memory and cognitive set-shifting. [262-273]
7. Neuroimaging studies reveal that estrogen enhances function of the frontal lobe of the brain in women during cognitive challenges. [274-281]
8. In postmenopausal women, estrogen enhances cognitive function by modulating information processing in the brain. [282-292]
9. Observational studies of menopausal women taking ERT show that the treatment is associated with better verbal memory, working memory, and visuospatial function, and with a lower risk of dementia. [293-302]
10. In naturally postmenopausal women, ERT is associated with better verbal fluency, working memory, and psychomotor speed. [303]
11. Studies show that estrogen exerts its cognition-enhancing efficacy by boosting the regeneration of brain neurons, protecting against programmed cell death (apoptosis), modulating transmission of electrical signals between each neuron, increasing blood flow to the brain, preventing formation of abnormal proteins in the brain (β-amyloid), and fighting inflammation and free radicals. [304-308]

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