Hormone replacement therapy (HRT) is used during menopause to treat hot flashes and other unpleasant side effects. A new study has found it may also aid brain health. Researchers followed more than 180,000 postmenopausal women in the UK for 13 years. Women who used HRT for at least a year were 10 percent less likely to develop dementia and 16 percent less likely to develop Alzheimer’s than those who didn’t.
The biggest benefit was seen in women who had surgically induced menopause — that’s menopause caused by a hysterectomy or an oophorectomy. They had a 26 percent lower risk of developing dementia. Women with a gene that put them at higher risk for dementia also saw big benefits from HRT. Additionally, women who started HRT young, when they were between 46 and 56 years old, had a lower risk of developing dementia than people who started when they were older. However, the study was observational, so it cannot prove that HRT was the cause.
“While HRT has long been prescribed primarily to relieve menopausal symptoms such as hot flushes and night sweats, this work suggests it may also play a role in long term cognitive health for some women,” said Prof. Anne-Marie Minihane of the Univ. of East Anglia, who led the study.
Women are at a higher risk for dementia than men. In part, it’s because they live longer — they have more of a chance to develop the condition. How menopause impacts the brain may also explain why women are at a higher risk.
Because the study can’t prove cause and effect, it could be that women who get HRT have some other difference about them that lowers their risk for dementia. Maybe they go to the doctor more regularly or request medical intervention for concerns earlier. In the study, they found that women using HRT generally have a higher average level of education.
“This study alone isn’t enough to tell us whether HRT should be used to reduce dementia risk, but it provides further evidence that the timing of HRT and a woman’s hormonal history may matter,” said Dr. Susan Kohlhaas, the executive director of research and partnerships at Alzheimer’s Research UK. “We now need research that can establish whether HRT itself is responsible for these differences in dementia risk and understand which forms of HRT may have an effect. Anyone considering starting or stopping HRT should speak to their GP about the potential benefits and risks for them.”
