- Before 2003, HRT, specifically the estrogen/progestin combination, was widely prescribed. However, a large randomized trial in 2003 found that this combination was associated with a two-fold increase in dementia risk among women older than 65.
- A recent Danish study examined over 60,000 women, tracking them from 2000 to 2018, with 5,589 of them developing dementia. It found that HRT use, even for short periods, was associated with a higher risk of dementia.
- The research faced challenges in distinguishing between reasons for HRT prescription and early symptoms of dementia, as both could have prompted the therapy. This complexity made it difficult to determine if the cognitive declines were directly caused by HRT.
- Some earlier studies had suggested that HRT initiated near the onset of menopause might protect against cognitive decline, but the Danish study contradicts those findings.
- Experts have expressed differing opinions regarding the study. Some believe it has limitations in establishing a direct link between HRT and dementia due to confounding factors, while others find the link plausible but emphasize the need for further research.
- The study highlights that lifestyle interventions and non-HRT approaches should be considered as initial options to manage menopausal symptoms. If HRT is prescribed, it should be for the shortest duration and lowest effective dose.
- Observational studies like this one cannot establish causality, so further research is necessary to investigate the potential causal relationship between menopausal hormone therapy and dementia.
Overall, the study adds to the existing knowledge on HRT and dementia, but its findings alone should not change medical practice. More research is needed to fully understand the complex relationship between HRT use, menopause, and cognitive health.