Prevention of dementia with sex hormones: a focus on testosterone and cognition in women.

Many perimenopausal women and their medical service providers have turned away from estrogens to treat their complaints. This mini-review investigated whether women could be prescribed androgens to promote cognitive function and to prevent dementia. Using PubMed and Google Scholar we identified several treatment studies but the majority had included insufficient controls. Tentatively some studies suggested that adding a testosterone to estrogen treatment promoted complex information processing over that of estrogens alone, but methodology of studies limited firm conclusions. While a larger study showed no effects in naturally menopausal women over that of placebo, some studies including only oophorectomized women showed positive effects of testosterone but these had only been carried out up to two months. Safety profiles of long-term androgen treatment, mode and type of treatment require more research. Observational data suggest that in older women who were not selected for optimal health, endogenous testosterone has a negative association with verbal memory, usually one of the first functions to decline in dementia.