Resumen
Objetivo: El objetivo del presente studio fue analizar el impacto de la Terapia de Reemplazo Hormonal (TRH) en el salud cognitiva de mujeres posmenopáusicas. Métodos: Para ello, se utilize una recompilación de investigaciones bibliográficas con enfoque cualitativo y carácter descriptivo, mediante una revisión integradora de la literature en revistas indexadas en las bases de datos PubMed y LILACS. Resultados: Los resultados demostraron que la TRH, cuando se inició durante la perimenopausia o en su período inicial, se relaciona con la mejora del rendimiento en varios campos del dominio cognitive, especialmente en lo deficit cognitive, la fluidez verbal, la memoria y la velocidad psicomotora, sin embargo, si se utiliza en el corto y mediano plazo. Por otro lado, destacaron posibles impactos negativos en las mujeres ya menopáusicas y edad avanzada. Consideraciones finales: Por lo tanto, los estudios indican una relación entre la salud cognitiva de las mujeres posmenopáusicas y la TRH, que es beneficiosa cuando se inicia temprano y posiblemente perjudicial cuando se introduce tarde, y se necesitan más estudios para demonstrar esta relación.
Referencias
ALDRIGHI JM e PIRES ALR. Efeitos dos estrogênios sobre a cognição, o humor e as doenças cerebrais degenerativas. Revista da Associação Médica Brasileira. 2001; 47(2): 87–7.
BERENT-SPILLSON A, et al. Distinct cognitive effects of estrogen and progesterone in menopausal women. Psychoneuroendocrinology, 2015; 59: 25-36.
CAMARGOS AL e NASCIMENTO E. Terapia de reposição hormonal e desempenho cognitivo na terceira idade. Estudos de Psicologia (Campinas). 2009; 26(4): 437–43.
COKER LH, et al. Postmenopausal hormone therapy and cognitive outcomes: the Women's Health Initiative Memory Study (WHIMS). J Steroid Biochem Mol Biol, 2010; 118(4-5): 304-10.
DUMAS JA, et al. Increased memory load-related frontal activation after estradiol treatment in postmenopausal women. Horm Behav, 2010; 58(5): 929-35.
GALDURÓZ RFS, et al. Effects of isoflavone on the learning and memory of women in menopause: a double-blind placebo-controlled study. Brazilian Journal of Medical and Biological Research, 2010; 43 (11).
GLEASON CE, et al. Effects of Hormone Therapy on Cognition and Mood in Recently Postmenopausal Women: Findings from the Randomized, Controlled KEEPS-Cognitive and Affective Study. PLoS Med, 2015; 12(6): 1001833.
HENDERSON VW, et al. Cognitive effects of estradiol after menopause: A randomized trial of the timing hypothesis. Neurology, 2016; 87(7): 699-708.
HERRERA AY, et al. Estradiol Therapy After Menopause Mitigates Effects of Stress on Cortisol and Working Memory. J Clin Endocrinol Metab, 2017; 102(12): 4457-4466.
HOGERVORST E, et al. Cognition and mental health in menopause: A review. Best Practice & Research Clinical Obstetrics & Gynaecology. 2021; 81.
JACOBS EG, et al. Accelerated cell aging in female APOE-ε4 carriers: implications for hormone therapy use. PLoS One, 2013; 8(2): 54713.
KANTARCI K, et al. Brain structure and cognition 3 years after the end of an early menopausal hormone therapy trial. Neurology, 2018; 90(16): 1404-1412.
MAKI PM. The Critical Window Hypothesis of Hormone Therapy and Cognition: A Scientific Update on Clinical Studies. Menopause, 2013; 20(6): 695–709.
MARINHO RM. Cognition in menopause: effects of estrogen therapy. São Paulo, tese – Universidade Federal de São Paulo. 2004.
PAE CU, et al. Thyroid hormones affect recovery from depression during antidepressant treatment. Psychiatry Clin Neurosci, 2009; 63(3): 305-13.
RAZ L, et al. Differential effects of hormone therapy on serotonin, vascular function and mood in the KEEPS. Climacteric, 2016; 19(1): 49-59.
RESNICK SM, et al. Postmenopausal hormone therapy and regional brain volumes: the WHIMS-MRI Study. Neurology. 2009; 72(2): 135-42.
RYAN J, et al. Characteristics of hormone therapy, cognitive function, and dementia: the prospective 3C Study. Neurology, 2009; 73(21): 1729-37.
SHERWIN BB e GRIGOROVA M. Differential effects of estrogen and micronized progesterone or medroxyprogesterone acetate on cognition in postmenopausal women. Fertil Steril, 2011; 96(2): 399-403.
SILVA AC e SÁ MF. Efeitos dos esteróides sexuais sobre o humor e a cognição. Archives of Clinical Psychiatry (São Paulo). 2006; 33(2): 60–7.
SILVA MFG. Cognitive Alterations in Women With Depressive Disorders During Perimenopause: the Impacto f Hormone Replacement Therapy With Transdermal Estradiol. São Paulo, tese (doutorado) – Faculdade de Medicina da Universidade de São Paulo. 2004.
SILVERMAN DH, et al. Differences in regional brain metabolism associated with specific formulations of hormone therapy in postmenopausal women at risk for AD. Psychoneuroendocrinology. 2011; 36(4): 502-13.
SMITH YR, et al. Impact of combined estradiol and norethindrone therapy on visuospatial working memory assessed by functional magnetic resonance imaging. J Clin Endocrinol Metab, 2006; 91(11): 4476-81.
WHARTON W, et al. Rationale and design of the Kronos Early Estrogen Prevention Study (KEEPS) and the KEEPS Cognitive and Affective sub study (KEEPS Cog). Brain Res, 2013; 1514: 12-7.
WROOLIE TE, et al. Differences in verbal memory performance in postmenopausal women receiving hormone therapy: 17β-estradiol versus conjugated equine estrogens. Am J Geriatr Psychiatry. 2011; 19(9): 792-802.
ZHANG T, et al. Effects of Hormone Therapy on Brain Volumes Changes of Postmenopausal Women Revealed by Optimally-Discriminative Voxel-Based Morphometry. PLoS One, 2016; 11(3): 150834.
