A recent study from Stanford University has revealed that women who underwent estrogen-only menopausal hormone therapy (MHT) had a lower chance of developing Alzheimer’s-related brain issues and dementia. This important research, published on August 12 in the journal Neurology, examined the post-mortem data of over 21,000 participants, including 258 women who used estrogen-only therapy and around 2,700 who did not.
The study focused on critical signs of Alzheimer’s disease, such as amyloid plaques and neurofibrillary tangles—two characteristic brain changes linked to dementia. Findings showed that women using estrogen-only therapy had a 35% lower risk of Alzheimer’s pathology and a 39% reduced chance of dementia throughout their lives. Many of these women had also likely experienced a hysterectomy.
Interestingly, the study discovered that some women who were part of the research and still alive demonstrated better memory function and were more capable of living independently, supporting these findings with blood and cerebrospinal fluid biomarkers. On average, the participants were about 70 years old.
The findings also suggest that starting menopausal hormone therapy during or immediately after menopause might provide even greater advantages. Researchers believe that because the women in the study started treatment later in life, the observed benefits may actually be understated. This new research offers a different perspective compared to older studies that suggested a higher risk of dementia associated with menopausal hormone therapy.
Co-author Dr. Jennifer Bruno highlighted that estrogen has protective effects on the brain. She explained that it helps reduce amyloid buildup and supports brain health by enhancing synaptic function and decreasing neuroinflammation, which aligns with the study’s findings of reduced Alzheimer’s changes in women using estrogen-only therapy.
Dr. Hadi Hosseini, the senior author of the study, emphasized the importance of examining actual brain damage to understand the presence of Alzheimer’s features. He acknowledged the study’s observational nature, which limits its ability to conclude a direct cause-and-effect relationship between hormone therapy and reduced Alzheimer’s risk. There may be other unmeasured factors influencing these results.
Even though this study doesn’t alter current medical recommendations, it underscores the necessity for more in-depth clinical trials to better understand how menopausal hormone therapy may impact cognitive health. Both researchers agree that more studies are needed to investigate this complex topic thoroughly.
Women’s health experts continue to stress the importance of individualized approaches to hormone therapy discussions, ensuring that choices are based on specific health needs and circumstances. The study was supported by funding from the National Institutes of Health.
