Therapeutic Strategies for Ovariectomy-Induced Vascular Dementia: Current Insights and Future Directions

Abstract

Background: Ovariectomy-induced vascular dementia (OIVD) is a cognitive disorder that occurs as a result of estrogen deficiency causing neurovascular dysfunction, oxidative stress, neuroinflammation and BBB breakdown. These pathological alterations are related to the development of vascular dementia and this gives evidence to effective treatment strategies. Purpose: The aim of this analysis is to discuss the disease process in OIVD, and examine the use of different forms of treatment, such as hormone replacement therapy (HRT), neuroprotective agents, antioxidants, and lifestyle changes. Other methods of therapy like the stem cell therapy, neurotrophic factors and the aid of gene therapy are also being discussed, which will help alleviate OIVD.

Procedures: An extensive literature review was performed and focused on works on mental decline caused by estrogen deficiency and the corresponding therapy. Peer-reviewed journals and clinical trials that tested the efficacy of estrogen replacement methods, antioxidant treatments, neuroprotectants, and regenerative Snyder-Martin medicine as a remedy to OIVD were used to obtain data.

Findings: There is a close association between estrogen deficiency after ovariectomy and neurodegeneration and neurocognitive decline. HRT has been successful in easing such symptoms to the extent that it replenishes the estrogen. Several neuroprotective agents, especially the phytoestrogens such as biochanin A have shown effectiveness in enhancing memory by adopting the antioxidant and anti-apoptotic mechanism. Antioxidant treatment of oxidative pathways and lifestyle, including diet changes and physical exercise, are also beneficial, and they assist in managing the disease. Moreover, new medical procedures such as the transplantation of stem cells and the modification of genes provide new opportunities to conduct research in the future on the reversal of disease development rather than its symptoms alone.

Conclusion: Estrogen insufficiency is a key problem of management OIVD. The exploratory therapies have the possibility of a broader modification of the disease, compared to traditional therapies, which only provide symptomatic relief. Further studies are needed to define the effectiveness and safety of these new measures.