Estrogen Treatment Impairs Cognitive Performance following Psychosocial Stress and Monoamine Depletion in Postmenopausal Women

Objective—Recent studies have shown women experience an acceleration of cognitive problems after menopause, and that estrogen treatment can improve or at least maintain current levels of cognitive functioning in postmenopausal women. However, we have previously shown that the negative emotional effects of psychosocial stress are magnified in normal postmenopausal women after estrogen treatment. This study examined whether estradiol administration can modify cognitive performance after exposure to psychological stress and monoamine depletion. Methods—Participants consisted of 22 postmenopausal women placed on either oral placebo or 17β-estradiol (E2) (1 mg/day for 1 month, then 2 mg/day for 2 months). At the end of the 3 month treatment phase, participants underwent three depletion challenges in which they ingested one of three amino acid mixtures: deficient in tryptophan, deficient in phenylalanine/tyrosine, or balanced. Five hours later, participants performed the Trier Social Stress Test (TSST), followed by mood and anxiety ratings and cognitive testing. Cognitive measures included tests of attention, psychomotor function, and verbal episodic memory. Results—E2-treated compared to placebo-treated participants exhibited significant worsening of cognitive performance on tasks measuring attentional performance and psychomotor speed. Similar trends for impairment were seen in measures of long-term episodic memory compared to placebotreated postmenopausal women. E2-treated participants also showed a significant increase in negative mood and anxiety compared to placebo-treated women after but not before the TSST, though the worsening of both cognitive and behavioral functioning were not correlated. These effects were independent of tryptophan or tyrosine/phenylalanine depletion and were not manifest before the TSST or at baseline. Address for Correspondence (PN): Clinical Neuroscience Research Unit, Department of Psychiatry, University of Vermont College of Medicine, 1 South Prospect St., Burlington, VT 05401, Voice:(802) 847-4560, Fax: (802) 847-7889, Mobile: (802) 373-4842, Paul.Newhouse@uvm.edu, Home Page: www.uvm.edu/~cnru. Conflicts of Interest/Disclosures: None. In addition, none of the sponsors had any role in the design or conduct of the study, management, analysis, and interpretation of the data, or preparation, review, or approval of the manuscript. A partial version of this work was previously presented as a poster at the Society for Neuroscience Annual Meeting, Washington, DC, November 19, 2008 NIH Public Access Author Manuscript Menopause. Author manuscript; available in PMC 2011 July 1. Published in final edited form as: Menopause. 2010 July ; 17(4): 860–873. doi:10.1097/gme.0b013e3181e15df4. N IH PA Athor M anscript N IH PA Athor M anscript N IH PA Athor M anscript Conclusions—These data suggest that the relationship between estrogen administration and cognitive/behavioral performance in postmenopausal women may be more complex than initially appreciated and that effects of psychosocial stress may influence whether hormone effects are beneficial.