Exploration of cyclical changes in memory and mood in postmenopausal women taking sequential combined oestrogen and progestogen preparations

Abstract

Objective To investigate the effect of progesterone on cognitive function, mood, sleep quality and libido when added to oestrogen in sequential combined hormonal replacement therapy regimens. Design Observational study over three hormonal replacement therapy cycles. Setting Menopause Centre of Ospedale Maternità, Bologna, Italy. Population Twenty-three postmenopausal women with an average of 70 months of amenorrhoea (range 12 to 234 months) on different sequential combined hormonal replacement therapy regimen for an average of 15 months (range 3–48) months. Methods Psychological testing for memory, mood, sleep quality and libido during the oestrogen only part of the cycle compared with the oestrogen-progestogen part of the cycle. Results Twenty women completed the six visits of the trial. The addition of progestogens to oestrogen appeared to benefit memory ( P<0.01) but worsened mood ( P<0.005). There was no evidence of change in other parameters such as sleep quality or libido. Conclusion The addition of progestogens improved memory above what was obtained with oestrogen alone. This effect did not depend on an improvement of mood since the latter worsened during the progestogenic phase of an hormonal replacement therapy cycle. Progestogen added to oestrogen did not significantly influence sleep or libido.