Central nervous System symptoms

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1. Changes in neurologic function such as increased irritability, mood disorders, mild depression, hot flushes, and sleep disturbances may arise during the perimenopausal transition. Estrogen replacement therapy is the most effective treatment for hot flushes. Hormone replacement with estrogen may help to reverse cognitive changes and improve function.

2. In elderly menopausal women, estrogens may retard the progression of dementia, especially Alzheimer's disease.

B. Sexual function. Libido may decrease at the time of the menopause. The use of testosterone with estrogen may induce a positive effect on mood and overall sense of well-being, particularly in women who have had their ovaries removed.

C. Cardiovascular symptoms. Coronary heart disease is the leading cause of death in women. Estrogens protect against coronary heart disease by lowering LDL cholesterol and increasing HDL cholesterol concentrations. Estrogen may also provide arterial vasodilation and increased perfusion.

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