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Hormone replacement and dementia

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Arnold's Pump Club promotes a healthier lifestyle and discusses hormone replacement therapy's impact on dementia risk. The brand references a 13-year study of 183,000 people, finding that hormone therapy may lower dementia risk, particularly in women who have had surgery to remove their uterus, ovaries, or both. They aim to provide a positive and informative online presence.

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Does Hormone Replacement Therapy Raise Dementia Risk?

The study behind the HRT dementia scare only tested women over a specific age. Here’s what a 13-year study of 183,000 people found, and who saw the biggest difference.

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Hormone therapy, menopause, and dementia risk

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Beyond The Headline

Does Hormone Therapy Raise Dementia Risk?

If you’re a woman going through menopause, hormone therapy can be an effective treatment for hot flashes and night sweats, and it can help you get back lost sleep. 

But many women avoid HRT because they’ve heard it raises dementia risk, and that fear is based on some very misleading research.

In 2003, the Women’s Health Initiative Memory Study gave women estrogen plus progestin pills and found about twice the rate of probable dementia. The data were real, but the details were important to the bigger picture. Every woman in that trial was 65 or older. Most women who use hormones start in their late 40s or early 50s.

When women took hormones near menopause, they found no harm to memory or thinking. 

Now a new study added a twist to the story. Researchers followed more than 183,000 women for about 13 years. Those who used hormone therapy for at least a year were 10% less likely to be diagnosed with dementia. But the actual numbers were small. About 2 in 100 women developed dementia during the study, so 10% worked out to roughly 2 fewer cases per 1,000 women.

But in women who’d had surgery to remove their uterus, ovaries, or both, the link was stronger: 26% lower risk. One theory is that removing the ovaries drops estrogen overnight instead of over years, and replacing a sudden loss may matter more than topping up a gradual one. But that’s a theory.

Even after adjusting for income, education, and health, this study can’t prove it’s the hormones. Women who choose hormone therapy tend to be healthier, better educated, and see doctors more often, all things linked to lower dementia risk. The study didn’t track which hormones women took, the dose, or whether they used pills or patches. Most participants were white and wealthier than average. 

At this point, the decision for HRT is one you should discuss with your doctor because it is not necessary for all women.

If your physician suggests hormone replacement therapy, it could be a helpful option. If you start hormone therapy around menopause, the best trials so far show no harm to memory or thinking. If you want to have the conversation with your doctor, here’s what you might want to consider.

If menopause hit before 45, or you had both ovaries removed before then: ask about hormone therapy. Early estrogen loss is linked to bone loss, heart disease, and dementia, and guidelines recommend treatment until about 51 or 52 unless there’s a medical reason to avoid it.

If menopause came around the usual age: let your symptoms decide. Hormone therapy cuts hot flashes by about 75% and can improve sleep in women whose nights are disrupted by them. Weigh that against your personal health history with your doctor.

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Arnold Schwarzenegger <[email protected]>
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Hormone replacement and dementia
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