By Mark Waghorn
Taking hormone pills to relieve night sweats and hot flashes could more than double women’s risk of Alzheimer’s, warns new research.
Dementia rates rose among both long and short-term users – including women under 55 for whom treatment is currently recommended
Hormone replacement therapy (HRT) is used to relieve common menopausal symptoms. Tablets, skin patches, gels, or creams contain estrogen and some also progestogen.
Lead author Dr. Nelsan Pourhadi said: “Menopausal hormone therapy was positively associated with development of all cause dementia and Alzheimer’s disease, even in women who received treatment at the age of 55 years or younger.
“The increased rate of dementia was similar between continuous and cyclic treatment.”
Results are based on 61,479 Danish 50 to 60-year-olds – 5,589 of whom went on to be diagnosed with dementia. Participants were tracked for almost two decades.
Those on HRT for more than 12 years were 74 percent more prone on average – with risk rising over twofold in some cases.
This dropped to 21 percent when HRT was prescribed for one year or less.
Dr. Pourhadi, a neurologist at Copenhagen University Hospital, said: “Increasing durations of use yielded higher hazard ratios.
“Associations persisted in women who received treatment at the age 55 years or younger. Findings persisted when restricted to late onset dementia and Alzheimer’s.”
The study failed to identify a causal link. Dr. Pourhadi urged further investigations to get to the bottom of the phenomenon.
The change of life can affect health, quality of life, and work productivity.
The number of women on HRT has surged in the last two years after a Davina McCall documentary on menopause.
The TV presenter, 54, spoke of struggling with hot flushes from the age of 44. Pharmaceutical companies reported a spike in demand following the broadcast in May 2021.
The NHS estimates nearly two million people in the country are now taking HRT, up by nearly a third from one year earlier, when 1.5 million women were prescribed tablets, skin patches and gels to manage menopause symptoms.
Menopausal symptoms may occur up to ten years before the last menstrual period. They can last more than a decade.
Benefits of HRT include reduced hot flushes in as many as 90 percent of patients with moderate to severe symptoms.
Others are improved blood lipid levels and a possible reduced risk of diabetes and fewer fractures of the hip, spine and other bones.
The study in the BMJ journal could shed light on why dementia affects more women than men.
Dr. Pourhadi said: “Even when controlling for differences in survival rates, the incidence of dementia among women is higher compared with that of men, suggestive of risk factors related to the female sex.
“Estrogen is known to have both neuroprotective and neurodamaging properties.”
Two decades ago the large-scale Women’s Health Initiative Memory Study in the US, the biggest of its kind, found dementia rates doubled in over 65s taking combined HRT.
Furthermore, MRI (magnetic resonance imaging) scans of a subset of participants showed the treatment was associated with loss of brain tissue loss, a finding strongly linked with cognitive decline and dementia.
Dr. Pourhadi said: “These results align with the observations of our study that show the positive association between estrogen-progestin exposure and the development of dementia – even in short term users.”
Previous evidence has linked HRT to breast cancer. But the risk is much lower in people aged 50 to 59 and in those who start therapy in the first 10 years of menopause,
Some studies show an increased risk of ischemic stroke in women older than 60 years who start therapy 10 years after the start of menopause. But the risk is low for those younger than 60.
For people with risk factors or those who do not want to take menopausal hormone therapy, non-hormonal therapies, such as some selective serotonin reuptake inhibitors (SSRIs) and other medications, can help alleviate symptoms.
Menopause marks the point when a woman hasn’t had a period for 12 months in a row.
It usually happens between the ages of 45 and 55, with 51 being the UK average.
It is a normal part of aging and occurs because the ovaries stop producing eggs, meaning a woman can no longer get pregnant naturally.
As a result, levels of the hormones the ovaries produce — estrogen, progesterone, and testosterone — drop.
Dr. Kejal Kantarci, a neuro-radiologist at the Mayo Clinic in Rochester, Minn., who was not involved in the study, said women on HRT may be predisposed to dementia.
He explained: “Confounding factors could be producing a spurious signal for higher dementia risk in younger women using hormone therapy for either a short or long duration.”
“These findings cannot inform shared decision-making about the use of hormone therapy for menopausal symptoms.
“Randomized clinical trials provide the strongest evidence on the effect of hormone therapy on dementia risk.”
Produced in association with SWNS Talker
Edited by Kyana Jeanin Rubinfeld and Jessi Rexroad Shull
