Cognitive health after menopause: Does menopausal hormone therapy affect it?

Stute, Petra; Johanna, W. A. M. Celie; Anne-Sophie, Koller; Christina, Giese; Wiebke, Wesemüller; Janka, Heidrun; Baumgartner, Sabrina

doi:10.1016/j.beem.2021.101565

Cited by 24 publications

(18 citation statements)

References 85 publications

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“…Estrogens modulate serotonin and noradrenalin balance, thereby influencing cognitive function and mood (Birkhäuser, 2021). HRT in menopause is believed to lower dementia risk if implemented before symptoms begin, and thus may be safely prescribed early for women free of dementia (Petra et al, 2021). Authors have reported conflicting data on HRT effects on cognition (Conde et al, 2021) and for OPRP it remains to be shown if this may provide useful corrections in mood, affect, or cognition.…”

Section: Discussionmentioning

confidence: 99%

Preliminary Cost Variance Modeling to Compare Autologous Intraovarian Platelet-Rich Plasma vs. Standard Hormone Replacement Therapy for Menopause Management

Sills¹,

Sl²

2021

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Background: Menopause symptoms and hormone replacement therapy (HRT) are among the most common reasons patients seek gynecological advice. Although at least half of all women in developed countries will take HRT during their lifetime, the treatment is not without risk and guidance on HRT is mixed. Greater awareness of negative HRT health effects from extended use has piqued interest in ‘safer options’. Menopause reversal with autologous ovarian platelet-rich plasma (OPRP) has brought this restorative approach forward for consideration, but appropriateness and cost-effectiveness require examination. Methods: HRT and OPRP data from USA were projected to compare cumulative 1yr patient costs using stochastic Monte Carlo modeling. Results: Mean±SD cost-to-patient for HRT including initial consult plus pharmacy refills was estimated at about $576±246/yr. While OPRP included no pharmacy component, an estimated 4 visits over 1yr for OPRP maintenance entailed ultrasound, phlebotomy/sample processing, surgery equipment, and incubation/laboratory expense, yielding mean±SD cost for OPRP at $8,710±4,911/yr (p<0.0001 vs. HRT, by t-test). Upper-bound estimates for annual HRT and OPRP costs were $1,341 and $22,232, respectively. Conclusions: While HRT and OPRP may have similar efficacy and safety for menopause therapy, they diverge sharply in cost-effectiveness. Most patients would likely find OPRP too complex, invasive, and expensive to be competitive vs. HRT. Although OPRP is an interesting and cautiously useful technique for selected menopause patients reluctant to use HRT, repurposing this infertility treatment for wider use appears inefficient compared to standard HRT currently available.

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Section: Discussionmentioning

confidence: 99%

Preliminary Cost Variance Modeling to Compare Autologous Intraovarian Platelet-Rich Plasma vs. Standard Hormone Replacement Therapy for Menopause Management

Sills¹,

Sl²

2021

Preprint

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“…These can be summarized as follows [15,17,97,98,100,105,[123][124][125]: • Improved mood and wellbeing.…”

Section: The Main Benefits Of Mhtmentioning

confidence: 99%

“…Prevention strategies should be guided by national and international guidelines[101][102][103].• MHT is unlikely to increase the risk of dementia or to have a detrimental effect on cognitive function if initiated before the age of 60 years. MHT should not be used to attempt to prevent cognitive decline or dementia as epidemiological evidence remains inconsistent[17,104,105]. A study published in 2021 using data from a large sample found that MHT use does not appear to increase the risk of developing dementia overall, but slightly increases the risk of developing Alzheimer's disease among long-term users of estrogenprogestogen therapies[106].…”

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confidence: 99%

Menopause, wellbeing and health: A care pathway from the European Menopause and Andropause Society

et al. 2022

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“…A recent meta-analysis described the results from multiple original articles on HRT and dementia development. Researchers concluded that menopausal hormonal therapy (MHT) might reduce the risk of AD by approximately 11–33% [ 101 ]. However, the risk reduction may substantially vary from the time MHT is initiated.…”

Section: Hormonal Therapeuticsmentioning

confidence: 99%

Therapeutics of Alzheimer’s Disease: Recent Developments

et al. 2022

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With increasing aging, dementia is a growing public health concern globally. Patients with dementia have multiple psychological and behavioral changes, including depression, anxiety, inappropriate behavior, paranoia, agitation, and hallucinations. The major types of dementia are Alzheimer’s disease (AD), vascular dementia (VCID), Lewy body dementia (LBD), frontotemporal dementia (FTD), and mixed dementia (MiAD). Among these, AD is the most common form of dementia in the elderly population. In the last three decades, tremendous progress has been made in understanding AD’s biology and disease progression, particularly its molecular basis, biomarker development, and drug discovery. Multiple cellular changes have been implicated in the progression of AD, including amyloid beta, phosphorylated tau, synaptic damage, mitochondrial dysfunction, deregulated microRNAs, inflammatory changes, hormonal deregulation, and others; based on these changes, therapeutic strategies have been developed, which are currently being tested in animal models and human clinical trials. The purpose of our article is to highlight recent therapeutic strategies’ developments, critically discuss current strategies’ failures, and propose new strategies to combat this devasting mental illness.

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Cognitive health after menopause: Does menopausal hormone therapy affect it?

Cited by 24 publications

References 85 publications

Preliminary Cost Variance Modeling to Compare Autologous Intraovarian Platelet-Rich Plasma vs. Standard Hormone Replacement Therapy for Menopause Management

Preliminary Cost Variance Modeling to Compare Autologous Intraovarian Platelet-Rich Plasma vs. Standard Hormone Replacement Therapy for Menopause Management

Menopause, wellbeing and health: A care pathway from the European Menopause and Andropause Society

Therapeutics of Alzheimer’s Disease: Recent Developments

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