According to a new study, the use of menopausal hormone therapy could be associated with a higher rate of dementia and Alzheimer's disease.
The study, conducted in Denmark, found that both long-term and short-term users of menopausal hormone therapy, particularly those around the age of menopause, had an increased risk of developing dementia.
The findings of this study align with the largest clinical trial conducted on this topic, emphasizing the need for further research to determine if there is a causal relationship between hormone therapy and dementia risk.
However, researchers caution against inferring a direct cause-and-effect relationship based solely on the observed associations.
NEW YORK, NEW YORK - AUGUST 30: Naomi Watts debuts the menopause greeting card collection with Em & Friends on August 30, 2022, in New York City.
Menopausal Hormone Therapy
Menopausal hormone therapy, commonly known as HRT, is often used to alleviate symptoms like hot flashes and night sweats. It involves the use of tablets containing either estrogen alone or a combination of estrogen and progestogen, as well as patches, gels, and creams.
Previous large observational studies have demonstrated a link between long-term use of menopausal hormone therapy and the development of dementia, supporting the findings of the Women's Health Initiative Memory Study, which is the largest clinical trial in this field.
However, the impact of short-term use of hormone therapy around the age of menopause, as currently recommended, still needs further investigation. The effect of various treatment regimens on dementia risk is still unknown.
To address these knowledge gaps, Danish researchers analyzed national registry data. They identified 5,589 cases of dementia and 55,890 dementia-free controls within a population of Danish women aged 50-60 years with no history of dementia or contraindications for hormone therapy.
The study took into account various factors such as education, income, hypertension, diabetes, and thyroid disease.
The findings indicated that individuals who had undergone estrogen-progestin therapy had a 24% elevated risk of developing dementia and Alzheimer's disease compared to those who had never used menopausal hormone therapy.
This increased risk was observed even among women who started treatment at the age of 55 years or younger. Moreover, the duration of therapy had an impact, as longer-term use was associated with higher rates of dementia.
It is worth noting that the type of treatment regimen, whether continuous or cyclic, did not significantly affect the risk. On the other hand, the use of progestin-only therapy or vaginal estrogen alone showed no association with the development of dementia.
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Further Studies Needed
The researchers highlight the need for further studies to determine whether these findings indicate a direct effect of menopausal hormone therapy on dementia risk or if underlying factors predispose women to both menopausal symptoms and dementia.
In a related editorial, US researchers support the call for additional studies and emphasize the importance of randomized clinical trials to provide stronger evidence regarding the effects of hormone therapy on dementia risk.
They also suggest that brain imaging biomarkers could potentially help identify the impact of hormone treatment on dementia pathology at an earlier stage.
While this study sheds light on the association between menopausal hormone therapy and dementia risk, further research is necessary to establish a clear cause-and-effect relationship and inform decision-making regarding the use of hormone therapy for menopausal symptoms.
The study was published in The BMJ.
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