After a long debate, dementia does not haunt women receiving hormone replacement therapy.

Hormone replacement therapy 

 After a long debate, dementia does not  haunt women receiving hormone replacement therapy.

A large-scale scientific review has revealed that there is no strong evidence linking hormone therapy after menopause to an increased risk of dementia, in one of the most comprehensive studies to date on this controversial topic in women's health, according to a report published by the science website ScienceAlert.

According to the study, which took the form of a comprehensive meta-analysis covering the health data of more than one million women, hormone therapy for menopause—medically known as hormone replacement therapy—does not appear to significantly increase or decrease the risk of developing dementia with age.

This review was commissioned by the World Health Organization, at a time when the organization's official guidelines still lack specific recommendations regarding the relationship between hormone therapy and dementia, despite the ongoing scientific and media debate surrounding the topic.

The study's lead researcher, Amy Spector from University College London, said the findings of this review will contribute to the World Health Organization's new guidelines on reducing cognitive decline and dementia, expected to be released in 2026.

Proven Benefits and Limited Risks

Health experts generally agree that hormone therapy, when prescribed correctly, is effective and safe in relieving menopausal symptoms such as hot flashes, night sweats, sleep disturbances, and decreased libido, in addition to its role in preventing osteoporosis.

According to the study, the improved quality of life for healthy women often outweighs the potential risks of treatment, which include a slight increase in the risk of blood clots and a limited increase in the likelihood of developing breast cancer in certain groups. It is important to note that these risks vary depending on when treatment begins, the type of hormones used, and the method of administration.

Although some previous research has linked menopause to cognitive changes, the new review found no conclusive evidence that hormone therapy (HRT) has a positive or negative effect on memory or dementia risk.

The findings indicated that most of the available studies were observational, meaning they could not establish a direct causal relationship. The results also showed considerable variation in the types of treatments, dosages, and timing of their use, making accurate comparisons difficult.

Only one randomized controlled trial found that estrogen use alone in women over 65 might be associated with a slightly increased risk of dementia, but the researchers described the strength of this evidence as "low" due to statistical inaccuracies.

These findings are consistent with the 2024 Lancet Dementia Commission report, which also concluded that there is insufficient evidence to link HRT to an increased or decreased risk of dementia. They also align with a recent FDA announcement removing stringent warnings from certain HRT products.

In conclusion, the researchers stressed that hormone therapy should not be used exclusively for the purpose of preventing dementia, but on the other hand, it does not constitute a proven risk factor for developing it, emphasizing the need for more high-quality research, especially in women who suffer from early menopause or have undergone hysterectomy or oophorectomy.