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J Clin Psychiatry. 2017 May;78(5):e490-e497. doi: 10.4088/JCP.15m10544.

Estrogen Replacement Improves Verbal Memory and Executive Control in Oligomenorrheic/Amenorrheic Athletes in a Randomized Controlled Trial.

Author information

1
Pediatric Endocrinology, Massachusetts General Hospital for Children, 101 Merrimac, Ste 615, Boston, MA 02114. cbaskaran@mgh.harvard.edu.
2
Pediatric Endocrine Unit, Massachusetts General Hospital for Children and Harvard Medical School, Boston, Massachusetts, USA.
3
Neuroendocrine Unit, Massachusetts General Hospital for Children and Harvard Medical School, Boston, Massachusetts, USA.
4
Department of Biostatistics, Massachusetts General Hospital for Children and Harvard Medical School, Boston, Massachusetts, USA.
5
Eating Disorders Clinical and Research Program, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.

Abstract

OBJECTIVE:

Both estrogen and exercise may have cognition enhancing benefits; however, young oligomenorrheic/amenorrheic athletes (OA) with estrogen deficiency have not been evaluated for cognitive deficits. Our objective was to determine whether 6 months of estrogen replacement will impact cognitive domains in OA. We hypothesized that estrogen replacement would improve verbal memory and executive control in OA.

METHODS:

We performed cognitive assessments at baseline and after 6 months in 48 OA (14-25 years) randomized to estrogen (EST+) (oral 30 µg ethinyl estradiol [n = 16] or transdermal 100 µg 17-β-estradiol patch [n = 13]) or no estrogen (EST-) (n = 19) in an ongoing clinical trial. Neurocognitive testing included California Verbal Learning Test-Second Edition (CVLT-II) (for verbal memory) and Delis-Kaplan Executive Function System Color-Word Interference Test (D-KEFS-CWIT) (executive control).

RESULTS:

On average, subjects (mean ± SEM age: 19.9 ± 3.1 years, body mass index: 20.6 ± 2.3 kg/m²) participated in 10.3 ± 5.9 hours per week of weight-bearing activities of their lower limbs. The EST+ group performed better for CVLT-II verbal memory scores for immediate recall over 6 months of therapy compared to EST- (P < .05) even after controlling for baseline scores and age. Changes in D-KEFS-CWIT scores over 6 months did not differ between the groups. However, the EST+ group had greater improvements in inhibition-switching completion time over 6 months compared with the EST- group after controlling for baseline scores and age (P = .01).

CONCLUSIONS:

OA show improvements in verbal memory and executive control following 6 months of estrogen replacement. These findings in athletes, who are in their prime of neurocognitive development, underscore the need for future studies exploring cognition in OA.

TRIAL REGISTRATION:

ClinicalTrials.gov identifier: NCT00946192.

PMID:
28297591
DOI:
10.4088/JCP.15m10544
[Indexed for MEDLINE]

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