Page 187 - The Memory Program How to Prevent Memory Loss and Enhance Memory Power

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her symptoms. Other antidepressant medications met the same fate. She refused to consider
psychotherapy. She also did not want to try any memory-enhancing exercises or related techniques,
so I asked her to start taking vitamin E 800 IUs daily. Adding the cholinesterase inhibitor donepezil
(Aricept) had no significant impact on her memory. Cynthia's general health habits (sound diet,
regular walks, no alcohol) were very good, so there wasn't much room for improvement there.

Over the next two years, Cynthia did not change very much. Occasional memory lapses persisted,
but without any worsening over time. Her neuropsychological testing showed no significant changes
during this period. My attempts to get her to reconsider estrogen therapy, or at least to discuss it with
her gynecologist, were met with stony reffisal. Her older sister Myra, who accompanied Cynthia for
some of her clinic visits, continued on her youthful, estrogen-filled way without any major health
problems.

The main female sex hormone, estrogen, is produced by the ovaries. As Cynthia and Myra
illustrate, its actions extend far beyond reproduction and sexual behavior. For Myra, estrogen
prevented not only memory decline but also the ravages of the aging process itself.

Effects of Estrogen

Estrogen helps to prevent a common malady of old age: osteoarthritis, in which bone decay
leads to generalized weakness, altered gait, and a stooped posture.
Postmenopausal women who take estrogen may actually increase their life span.
Estrogen's effects in the brain are less well recognized, but a lack of this hormone can give rise
to memory loss.

Genetic Factors Influence Treatment Response

In all branches of medicine, there is a general rule that genetic factors play an important role in
predicting treatment response. If one family member responds to a treatment, the other family
member will likely respond to the same treatment. I am convinced that estrogen could have
accomplished for Cynthia what it had achieved for Myra, and that its effects on both mild depression
and memory loss would have been far greater than the standard antidepressant and antimemory-loss
medications that she received. My guess is that her primary problem was estrogen deficiency (blood
estrogen levels are