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Hormone Therapies Tied to Brain Changes in Menopausal Women

Circulating levels of pituitary-ovarian hormones linked to changes in WMH in menopausal women

menopausal woman and doctor

WEDNESDAY, June 17, 2020 (HealthDay News) -- In recently menopausal women using hormone treatment (HT), circulating levels of pituitary-ovarian hormones are associated with changes in white matter hyperintensities (WMH), according to a study published online June 8 in Menopause.

Juliana M. Kling, M.D., M.P.H., from the Mayo Clinic in Scottsdale, Arizona, and colleagues enrolled 78 women in the Kronos Early Estrogen Prevention Study who underwent brain magnetic resonance imaging and blood collection before and after 48 months of random assignment to oral conjugated equine estrogen, transdermal 17β estradiol (tE2), or placebo pills and patches. In the first 12 days of the month, women in the active treatment groups also received oral micronized progesterone. At baseline and after 48 months of HT, estradiol (E2), estrone (E1), follicle-stimulating hormone (FSH), and luteinizing hormone (LH) were measured in serum. Longitudinal change in WMH volume was examined.

The researchers observed no association for serum levels of FSH, LH, E1, or E2 with WMH volume at baseline. Smaller increases in WMH after 48 months of treatment were associated with greater decreases in FSH from baseline in the tE2 group and greater increases in E1 in both treatment groups. There were no associations noted for changes in LH with changes in WMH in any group.

"The relationships seen may help explain why different HT formulations lead to different structural brain changes in menopausal women and differentially affect mood, anxiety, risk for hypertension, and small vessel ischemic disease," the authors write.

Study medications were supplied in part by Bayer HealthCare and Abbott Pharmaceuticals.

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