Early Menopause Hormone Treatment and Cognition

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-05-31

Study Completion Date

2012-03-31

Brief Summary

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The objective of this study is to evaluate the neurobiological effects of hormone therapy (HT) in healthy early postmenopausal women. The studies proposed in this project seek to define the association between different hormone forms (estradiol only and progesterone only) versus placebo on brain functional measures. The functional measures will include the performance of the volunteers on a comprehensive neuropsychological testing battery, and the brain functional responses to episodic memory (verbal and non-verbal) challenges as well as emotional processing determined with functional magnetic resonance imaging (fMRI).

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Detailed Description

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Specific Aims

Aim 1. To examine the effects of estradiol alone on brain functioning in early post-menopausal women during verbal and non-verbal cognitive tasks.

Hypothesis: It is expected that with estradiol treatment brain activation will be more prominent in the hippocampus and prefrontal cortical areas compared to placebo. The magnitude of activation in these regions will be positively correlated with task performance in the scanner and with the results of neuropsychological tests assessing verbal and non-verbal delayed recall.

Aim 2. To determine the effects of progesterone alone on brain functioning in early postmenopausal women during verbal and non-verbal cognitive tasks.

Hypothesis: It is expected that with progesterone treatment brain activation in the hippocampus and prefrontal cortical areas will be decreased compared to both the placebo condition (within subjects) and the estradiol condition (between subjects). Interindividual variations in the magnitude of activation in these regions will be positively correlated with task performance in the scanner and with the results of neuropsychological tests assessing verbal and non-verbal delayed recall.

Aim 3. To determine the individual effects of estradiol and progesterone on brain functioning in early postmenopausal women during emotional processing stimuli.

Hypothesis: During negative stimuli estradiol-treated women compared to placebo group, are expected to have increased activity in the amygdala, posterior cingulate, and orbitofrontal cortex, while in progesterone-treated women compared to placebo, decreased activity is expected in these brain regions.

Conditions

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Menopausal Syndrome

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Intervention Type DRUG

One Progesterone capsule (200mg) once a day, at the same time each day, for 90 days; followed by one Placebo capsule (to mirror Progesterone capsule to slough endometrial lining in Estradiol recipients) once a day, at the same time each day, for 10 days ; followed by one Placebo capsule once a day, at the same time each day, for 90 days.

Interventions

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Estradiol (E2)

One Estradiol capsule (1mg) once a day, at the same time each day, for 90 days; followed by one Progesterone (200mg) once a day, at the same time each day, for 10 days to slough endometrial lining; followed by one Placebo capsule once a day, at the same time each day, for 90 days.

Intervention Type DRUG

Progesterone (P10) x90

One Progesterone capsule (200mg) once a day, at the same time each day, for 90 days; followed by one Placebo capsule (to mirror Progesterone capsule to slough endometrial lining in Estradiol recipients) once a day, at the same time each day, for 10 days ; followed by one Placebo capsule once a day, at the same time each day, for 90 days.

Intervention Type DRUG

Progesterone (P10) x10

One Progesterone (200mg) capsule once a day for 10 days, to slough endometrial lining for patients taking Estradiol. Patients taking Progesterone will take an equivalent Placebo capsule during this time period.

Intervention Type DRUG

Other Intervention Names

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E2 P10 P10

Eligibility Criteria

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Inclusion Criteria

* Postmenopausal women
* Ages 45-55, 6 - 36 months from their last menstrual period.

Exclusion Criteria

* Left handedness
* Acute medical illness
* Neurologic illness
* Psychiatric illness
* Heart disease
* Thromboembolic disease
* Liver disease
* Uncorrected thyroid disease
* Diabetes
* Neurological disease
* Porphyria
* Allergy to estradiol
* Progesterone or lactose
* Lactose intolerance
* Claustrophobia
* Contraindications to MRI (including pacemakers, surgical clips or metallic surgical devices)
* Smoking within the last 3 years
* Use of hormones within the last 3 months
* Current or past history of substance abuse
* History of head injury or loss of consciousness
* Medications with actions on the central nervous system
* Endometrial lining greater than 5mm
* Ovarian pathology on ultrasound
* Abnormal mammogram
* Migraines
* Fasting cholesterol \>300 mg/dl, and fasting triglycerides \>300 mg/dl
* Creatinine level \> 1.5 mg/dl
* Aspartate transaminase (AST) or Alanine transaminase (ALT) greater than two times the top normal range
* Follicle stimulating hormone (FSH) values \<40 IU/L
* estradiol \>40 pg/ml.
* Subjects with HAM-D score \> 8, HAM-A \> 6 during screening will not be eligible.

Minimum Eligible Age

45 Years

Maximum Eligible Age

55 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes