Decoding Dementia: The Complex Link Between Menopause and Cognitive Health – ARC Summit

Several large observational studies have indicated that hormone replacement therapy (HRT) is associated with a reduced rate of Alzheimer’s disease and other forms of dementia. However, the Women’s Health Initiative Memory Study (WHIMS), which focused only on women aged 65 and older, found an increased rate of cognitive decline, suggesting negative effects on dementia in this age group. Despite these findings, when considering the broader cohort from the WHI with an average baseline age of 63 years, the use of conjugated estrogens (CE) with or without medroxyprogesterone acetate (MPA) was linked to a significant reduction in mortality attributed to dementia, particularly in younger populations within the study.

The WHI’s findings underscore the importance of age and timing in the efficacy of HRT related to cognitive health. Other studies, like the WEST study, have further explored these dynamics. Regarding the administration of HRT, options include oral and transdermal estrogen, various forms of progesterone, and compounded products from specialty pharmacies.

As we discuss the evolution of menopause treatments, it’s interesting to note the historical changes—from the simplistic use of fans in the 1960s to address menopause symptoms to the sophisticated hormone treatments available today, such as pills and transdermal patches, reflecting significant advancements in our approach to managing menopause.