Progesterone and human cognition

Abstract

Progesterone is a neurosteroid and a neuroactive steroid, produced primarily by the corpus luteum and the placenta. In some animal models, progesterone affects cognitive performance, and its potential role in human cognition is especially germane to women. This role can be investigated through associations between peripheral concentrations of progesterone in blood or saliva and neuropsychological test results, through differences in cognitive profiles between women using menopausal hormone therapy with and without a progestogen, and through clinical trials. In naturally cycling reproductive-age women and pregnant women, there is no consistent relation between progesterone levels and cognition. In postmenopausal women within 6 years of menopause and not using hormone therapy, progesterone levels are positively associated with verbal memory and global cognition, but reported associations in older postmenopausal women are null. Some observational studies of postmenopausal women using hormone therapy raise concern of a small deleterious cognitive effect of progestogen (medroxyprogesterone acetate was most often reported in these studies), but this association may due to confounding factors. Small, short-term clinical trials of progesterone show no meaningful effect on cognition. The quality of evidence is low, but overall findings do not reveal consistent, clinically important effects of progesterone on cognitive function in women.

Endocrine Responses to Sport-Related Brain Injury in Female Athletes: A Narrative Review and a Call for Action

“…Therefore, it appears that, in the wake of SRBI, a cascade of NED may occur that suddenly decreases the amount of progesterone. Regardless of menstrual cycle phase, progesterone is normally present in higher concentrations in the female brain compared to males [63]. Consequently, males experience a less rapid and overall lower magnitude of progesterone withdrawal following SRBI and overall, appear less affected by the suppression of the HPG axis and the withdrawal of progesterone, compared to females [40,48].…”

Gestagengabe in der Menopause: Was sind Unterschiede, Vorteile und Nachteile der einzelnen Präparate?

“…Kleine, kurzzeitige klinische Studien zu Gestagenen zeigen keine bedeutsamen Negativeffekte auf die Kognition. Die Qualität der Evidenz ist zwar gering, aber insgesamt scheinen Gestagene keine klinisch wichtigen Effekte auf die kognitive Funktion von Frauen zu haben [39].…”

Liquid chromatography–mass spectrometry applications for quantification of endogenous sex hormones

“…Furthermore, this hormone plays a role in pregnancy maintenance, and exogenous progesterone may be administered during early pregnancy to counteract deficiencies (Coomarasamy et al, 2015; Quaas & Hansen, 2016; Ransom & Murtha, 2012). Additionally, evidence to support the role of progesterone in cognition and its neuroprotective effect in traumatic brain injury in animals has recently surfaced (Henderson, 2018; Stein & Wright, 2010). Finally, abnormal progesterone levels have been implicated in increased risk of some autoimmune diseases in females, including systemic lupus erythematosus, rheumatoid arthritis, multiple sclerosis, autoimmune thyroid disease and some other little‐known autoimmune diseases such as Sjӧgren syndrome (Hughes, 2012).…”