The hormone debate: The Vilification and Redemption of Estrogen Replacement (part 3)

In our 3^rd installation of looking at postmenopausal hormone replacement, we will discuss the effect it has on memory and cognition, specifically Alzheimer’s. Let’s start with some pretty important statistics: 1 out of 6 women at the age of 65 will develop Alzheimer’s, compared to 1 out of 11 for men. More than half of Americans living with Alzheimer’s are women. Women are twice as likely to develop Alzheimer’s as they are breast cancer in their 60’s.

The medications we currently have for Alzheimer’s dementia do not reverse or halt the disease process, rather it tends to just slow down the inevitable. However, what if I told you there actually was a way to prevent ever developing Alzheimer’s in the first place.

In 2014, observational research on women taking hormone replacement therapy was published that noted a 29%-44% reduction in cognitive decline in younger postmenopausal women. The evidence was considered preliminary and further studies were warranted.

In 2018, a study was discussed at the Alzheimer’s Association International Conference and cited in the Neurology Advisor, discussing the effects hormone replacement therapy had on cognition. They looked at the data collected from women aged 40-84 and found some promising results. Women that were on hormone replacement therapy for 2-5 years had the greatest risk reduction for Alzheimer’s dementia.

These findings are in opposition to the WHI trials, which found HRT use to be detrimental. However, if you are doing your own research, make sure you take into account that the women in the Woman’s Health Initiative were beyond the “10 year window” of benefit and over the age of 65. This was not representative of the primary base of women who would be seeking HRT in the first place.

As always, I would like to reiterate that this is not medical advice. If you feel you or someone you know could benefit from HRT it is important to sit down and have a detailed conversation with your provider.

…..stay tuned next week when we discuss HRT and its relationship to breast cancer.

-Brooke Rieth NP