Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Affairs Hospital, Madison, Wisconsin.
Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Affairs Hospital, Madison, Wisconsin; Wisconsin Alzheimer's Disease Research Center (ADRC), Madison, Wisconsin; Division of Geriatrics and Gerontology, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin.
Fertil Steril. 2014 Apr;101(4):898-904. doi: 10.1016/j.fertnstert.2014.02.025.
Results of the Women's Health Initiative (WHI) and Women's Health Initiative Memory Study (WHIMS) suggested that hormone therapy (HT) may be detrimental to cognitive health. This article reviews clinical studies that address issues relevant to those results.
Literature review.
INTERVENTION(S): A search of Pubmed and Web of Science was conducted using the search terms HT and cognition, HT and mood. Clinical and observational studies were selected if they were published after the year 2000. Theories of HT mechanisms of action, pharmacology, biology, and observational and clinical trials are discussed.
RESULT(S): Although observational and clinical trials show conflicting findings, methodologic considerations must be acknowledged. HT formulation and dose, route of administration, timing of initiation, length of treatment, and health of participants all contribute to inconsistencies in results. Transdermal estradiol and micronized progesterone administered at time of menopause are generally associated with cognitive and affective benefit.
CONCLUSION(S): At the present time, results from existing studies are equivocal regarding the benefits of HT on cognition and affect. Future studies, such as the Kronos Early Estrogen Prevention Study (KEEPS), should address methodologic inconsistencies to provide clearer answers to this important question.
妇女健康倡议（WHI）和妇女健康倡议记忆研究（WHIMS）的结果表明，激素疗法（HT）可能对认知健康有害。本文综述了针对这些结果的相关问题的临床研究。
文献回顾。
使用 HT 和认知、HT 和情绪等搜索词在 Pubmed 和 Web of Science 上进行了搜索。如果研究是在 2000 年以后发表的，则选择临床和观察性研究。讨论了 HT 作用机制、药理学、生物学以及观察性和临床试验的理论。
尽管观察性和临床试验的结果存在矛盾，但必须承认方法学的考虑因素。HT 的制剂和剂量、给药途径、起始时间、治疗时间和参与者的健康状况都导致结果不一致。在绝经时给予的经皮雌二醇和微粒化黄体酮通常与认知和情感获益相关。
目前，关于 HT 对认知和情感的益处，现有研究的结果存在争议。未来的研究，如 Kronos 早期雌激素预防研究（KEEPS），应该解决方法学上的不一致性，为这个重要问题提供更明确的答案。
