Abstract
During the menopausal transition, which begins four to six years before cessation of menses, middle-aged women experience a progressive change in ovarian activity and a physiologic deterioration of hypothalamic-pituitary-ovarian axis function associated with fluctuating hormone levels. During this transition, women can suffer symptoms related to menopause (such as hot flushes, sleep disturbance, mood changes, memory complaints and vaginal dryness). Neurological symptoms such as sleep disturbance, “brain fog” and mood changes are a major complaint of women transitioning menopause, with a significant impact on their quality of life, productivity and physical health. In this paper, we consider the associations between menopausal stage and/or hormone levels and sleep problems, mood and reduced cognitive performance. The role of estrogen and menopause hormone therapy (MHT) in cognitive function, sleep and mood are also discussed.
Highlights
During the menopausal transition, which begins four to six years before cessation of menses, middle-aged women experience a progressive change in ovarian activity and a physiologic deterioration of hypothalamic-pituitary-ovarian axis function associated with fluctuating hormone levels
Young menopausal women without contraindication to menopause hormone therapy (MHT) and with impaired quality of life because of night sweats, vasomotor symptoms or disrupted sleep can benefit from MHT with several studies providing reassurance that MHT does not adversely affect cognition in these women
During menopausal transition women experience dramatic fluctuations in the levels of the sexual hormones estradiol, progesterone and androgens, which are potentially responsible for modifications in behavior, cognition, mood and sleep
Summary
During their lifetime women experience dramatic fluctuations in the levels of the sexual hormones estradiol, progesterone and androgens when going through the different stages of life, from menarche to menopause [1] These fluctuations have a significant impact on the whole body including the central nervous system (CNS) and can be responsible for modifications in behavior, cognition and mood. Sex steroids are able to modify several functions including behavior, cognition and memory, sleep, mood, pain and coordination, amongst others They exert their function through receptors both in the nuclei and along the membranes at synapsis, spine and mitochondria. Progesterone is a potent regulator of neurogenesis, cell survival and bioenergetic systems They do not have synergistic action and their co-administration leads to a lower response than with the administration of a single compound [15,16]. The Influence of Menopausal Transition and Menopause Hormone Therapy on Cognition
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