Clinical trial of botanicals for memory loss in menopause

Researchers at the University of Illinois at Chicago are investigating whether hormone therapy and two alternative herbal products can lessen memory and other cognitive problems experienced by menopausal women.

“Decline in mental skills and difficulty remembering things, finding words, paying attention — these are all common complaints of midlife women,” said Pauline Maki, associate professor of psychiatry and psychology in the UIC Center for Cognitive Medicine.

According to the Seattle Midlife Women’s Health Study, 63 percent of women making the transition from pre- to postmenopause say that their ability to remember names, telephone numbers and other information had deteriorated. The reasons for the deterioration are not clear, but the therapies being tested at UIC have different modes of action that might provide clues to the underlying cause.

The investigation is part of a larger study to determine whether black cohosh and red clover offer an alternative to hormone therapy in relieving hot flashes, the most common symptom of menopause. Up to 112 women will be recruited to participate in the study. They will be randomly assigned to one of four groups taking black cohosh, red clover, Prempro (a combined estrogen and progestin hormone replacement drug) or a placebo. Health effects will be closely monitored over about 14 clinic visits.

Before and after the 12 months, participants will complete a 1.5-hour battery of paper-and-pencil tests assessing memory, attention and concentration and mood. Previous research has shown that age and hormones affect performance on many of these tests.

Women in the study will have the option to undergo brain scans before and after the treatment period. “The goal of the scans is to pinpoint areas in the brain where different therapies may be acting to influence memory,” Maki said. “Interestingly, menopause per se has little influence on cognitive function in midlife women, but menopausal symptoms do,” Maki said. “That is, perimenopausal women who complain of sleep disturbances, depression and irritability perform worse on cognitive tests than women who have fewer such symptoms, suggesting that therapies to enhance mood and sleep may also help improve cognitive function.”

According to Maki, black cohosh, a wildfower native to forests in North America, has been shown in preliminary studies to bind to serotonin receptors, as antidepressant medications do. That action could possibly help cognition, but to date, no studies have tested the effects of black cohosh on memory in midlife women.

Red clover, a small perennial herb native to Europe, Central Asia and northern Africa, contains phytoestrogens, naturally occurring compounds found in soy and certain plants, that are estrogen-like in structure and function. A few limited studies have yielded some evidence that phytoestrogens can improve memory and mental flexibility.