Ageing perspective on cognitive outcomes from ancillary reproductive hormone adjustments

In addition to primary reproductive functions, gonadal hormones play an important role in regulating neural mechanisms across the human lifespan. The ageing-related decline in their activity has been linked to cognitive impairments in otherwise healthy women, contributing to higher incidents of post-menopause dementia. Given the growing utility of gonadal steroids for birth control, as well as for compensatory treatment of menopause and oophorectomy symptoms, and adjuvant transgender therapy, their long-term effects on neural mechanisms warrant comprehensive assessment. In this article, we present an ageing perspective on the cognitive outcomes of contraceptive and ancillary medical use of gonadal hormones and discuss their effects on the risk of cognitive impairments and late-life dementia. Despite rising data supporting the ameliorative effects of reproductive hormones on cognitive facilities, their impact varies depending on study design and type of intervention, implying dynamic neuro-endocrine interactions with complex compensatory mechanisms. Elucidating differential effects of reproductive hormone adjustments on cognition is expected not only to shed light on important aspects of brain ageing and dementia but to facilitate their use in personalized medicine with better safety and therapeutic outcomes.