Dementia and Menopause: Is Hormone Therapy a Risk Factor for Memory Loss?

A new study analyzed the link between menopausal hormone therapy and the risk of developing dementia in terms of treatment type, duration, and age at usage.

Highlights:

Hormone replacement therapy (HRT) used to treat menopause symptoms may increase a woman’s risk of severe diseases
New study findings discuss the relationship between menopausal hormone therapy and the risk of dementia and Alzheimer’s disease
Evaluating more about the effects of hormone therapy on dementia is important to inform clinical care

A new study published in The BMJ revealed that women who received menopausal hormone treatment at the age of 55 or younger faced an increased risk of developing dementia and Alzheimer's disease. Interestingly, the study found that the rate of risk was comparable between continuous and cyclic treatment regimens.

Women around the world use menopausal hormone therapy - also known as hormone replacement therapy (HRT) to help alleviate the symptoms of menopause. HRT has some known side effects, like migraine and nausea () .

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‘Dementia risk persisted in women who only received combined menopausal hormone therapy at age 55 years or even younger.#dementia #menopause #Hormone replacement therapy’

Previous studies have shown that women who use certain types of HRT may increase their risk for stroke, gallbladder issues, and certain cancers, including breast and endometrial cancers. Now, their association with dementia and Alzheimer’s disease has been discussed.

What is Menopausal Hormone Therapy?

A woman typically enters menopause between the ages of 45 and 55. The symptoms of menopause include hot flashes, night sweats, irregular periods, vaginal dryness, sleeping problems, and mood changes.

Menopause is a natural aging process, but these changes could be a discomfort. To reduce these symptoms, hormone replacement therapy is commonly used. Other options are low-dose hormonal birth control pills and antidepressants. Additionally, certain lifestyle changes can help provide relief from some symptoms.

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HRT aims to balance the amount of the hormones estrogen and progesterone in a woman’s body. Depending on the situation and needs, there are two main types of menopausal hormone therapy a doctor may prescribe. It is either estrogen-only therapy or combination therapy including both estrogen and progesterone ().

Is There a Link Between Menopausal Hormone Therapy and Dementia Risk?

In a new study, researchers wanted to investigate the association between the use of menopausal hormone therapy as recommended in guidelines and the risk of dementia. They also wanted to compare continuous versus cyclic treatment regimens.

They analyzed data from a national registry database, including about 5,600 women with dementia and almost 56,000 age-matched women who had no dementia diagnosis. The data spanned from 2000 to 2018 time period.

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The average age of dementia diagnosis for the participants was 70 years. Before receiving a diagnosis, 32% of women with dementia and 29% of controls had received estrogen-progestin (a synthetic form of progesterone) therapy from an average age of 53. The average duration of therapy was 3.8 years for women with dementia and 3.6 years for the control group.

Upon analysis, they found women who received estrogen-progestin therapy had a 24% increased risk of developing all-cause dementia and Alzheimer's disease. This effect was observed even among women who received the treatment at or before the age of 55 ().

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Future studies should determine whether these findings represent an actual effect of menopausal hormone therapy on dementia risk, or whether they reflect an underlying predisposition in women in need of these treatments.

References:

Postmenopausal hormone replacement therapy: scientific review - (https://pubmed.ncbi.nlm.nih.gov/12186605/)
Use of postmenopausal hormone therapy and risk of Alzheimer’s disease in Finland: nationwide case-control study - (https://www.bmj.com/content/364/bmj.l665)
Menopausal hormone therapy and dementia: nationwide, nested case-control study - (https://www.bmj.com/content/381/bmj-2022-072770)

Source-Medindia