Your older sister was just telling me
“Your older sister was just telling me that she is no longer as interested in her hobbies,” I said.
Myra looked at her sister Cynthia, turned toward me with a puzzled expression, and then suddenly
laughed. ‘‘You kiddin’ me? She’s not older. Cynthia, my little sister? She’s six years younger than I
am!”
I simply couldn’t believe it. I had guessed that Myra was fifty, not seventy years old. And with my
earlier impression of Cynthia being eighty rather than sixty-four, the contrast between the two sisters
was even more striking to me. So I asked Myra about her own health habits. She went through the
usual litany: a sound diet, regular exercise, no smoking, low alcohol intake, and a mellow, low-stress
approach to life. Finally, she revealed that she was taking Premarin, a standard estrogen-replacement
therapy for postmenopausal women.
I turned to ask her sister Cynthia if she had thought of taking estrogen herself.
“My aunt died of breast cancer, so I won’t take the risk,” she replied.
Myra explained that she had no problems on estrogen and that she had regular, frequent checkups
with her gynecologist, including regular mammograms and pelvic exams. But Cynthia remained
adamant that because there was a risk of cancer, she would not take estrogen.
Keeping this information in the front of my mind, I completed the diagnostic workup for Cynthia’s
memory loss, and possible depression. There were no abnormalities on neurological examination or
any laboratory test, including MRI scan of the brain. Her neuropsychological testing showed only
minimal deficits, which may have been due to mild depression. A twelve-week treatment course with
the antidepressant medication paroxetine led to only slight improvement in 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.
Taken From: The Memory Program How to Prevent Memory Loss
and Enhance Memory Power
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