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The research, led by Bodyl Brand, a researcher at the University of Oxford, in collaboration with Professor Iris Sommer, Dr Heidi Taipale and others at universities in the Netherlands, Finland and Sweden, supports clinical evidence that oestrogen has protective effects on the brain.
Researchers studied the medical records of 3,488 women in Finland who had previously been diagnosed with schizophrenia or schizoaffective disorder (SSD). They compared how many times the women were hospitalised with the condition during periods when they were using menopausal hormone therapy (MHT), also known as hormone replacement therapy (HRT), to when they were not using the treatment.
They found using MHT/HRT, which contains oestrogen, was associated with a 16 per cent lower risk of psychosis relapse in women of menopausal age (40-62 years of age). Brand says:
We found that the use of menopausal hormone therapy was associated with a lower relapse risk for psychosis as compared to non-use and was specifically effective in preventing relapse when started before the age of 56."
While existing evidence suggests that women have less severe presentations of SSD than men when they are first diagnosed, outcomes deteriorate as they age, particularly after the age of 45. At that point, women are more likely to experience psychosis relapse than both younger women and men. Antipsychotic medicines also become less effective for women as they reach menopausal age, according to previous research by the team.
Brand adds:
Women with schizophrenia or schizoaffective disorder of menopausal age form an exceptional group which is susceptible to psychosis relapse, but also to side effects of antipsychotic medication.
Therefore, it is important to ensure there are appropriate systems, services and support in place to support women in the event of relapse. But, given its potential and safety, continued efforts are also needed to make menopausal hormone therapy more accessible and acceptable in this vulnerable group of women."
Oestrogen has been shown in other studies to act as an antioxidant and improve the brain’s ability to adapt, grow and work effectively. The presence of oestrogen naturally declines in women in the years leading up to menopause (the perimenopause).