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Abstract：
The results of the WHI, which reported a doubling of the risk of Alzheimer\'s disease (AD) and a decline in cognitive function in women who were given menopause hormone therapy (MHT), have raised concerns on the deleterious impact of MHT on the central nervous system. Such as for the cardiovascular system, the very late age of initiation of treatment and the nature of the molecules have led to conclusions that cannot be extended to women in their fifties, at the onset of their menopause which is the usual age of MHT initiation. The molecules, which are used in France, 17-beta estradiol and natural progesterone (or its isomer, dydrogesterone) are very different from the equine conjugated estrogens and medroxyprogesterone acetate used in the WHI. It can now be stated that if MHT is started within the window of opportunity (i.e. before the age of 60 or within the first 10years after the beginning of menopause) no deleterious effect on cognition is observed. Moreover, cognition remains relatively stable at the beginning of menopause since the cognitive reserve as well as the different compensation circuits allow compensation for estrogen deficiency. This does not in any way prejudge a possible positive effect of MHT on AD, which is very difficult to demonstrate, as the age of onset of this dementia is very late, 20 or 30years after the initiation of treatment.
摘要：
WHI的结果，报告说，在接受更年期激素治疗（MHT）的女性中，阿尔茨海默病（AD）的风险增加了一倍，认知功能下降，引起了人们对MHT对中枢神经系统的有害影响的担忧。比如心血管系统，开始治疗的年龄和分子的性质已经得出了不能扩展到50多岁女性的结论，在更年期开始时，这是MHT开始的通常年龄。分子，在法国使用，17-β雌二醇和天然孕酮(或其异构体，地屈孕酮）与WHI中使用的马结合雌激素和醋酸甲羟孕酮非常不同。现在可以说,如果MHT在机会窗口内(即在60岁之前或在绝经开始后的前10年内)开始,则没有观察到对认知的有害影响。此外，由于认知储备以及不同的补偿回路允许对雌激素缺乏进行补偿，因此在更年期开始时认知保持相对稳定。这不会以任何方式预先判断MHT对AD可能的积极影响，这很难证明，由于痴呆症的发病年龄非常晚，治疗开始后20或30年。
