on PinterestThere is no link between MHT and dementia risk, according to a new review.
on PinterestThere is no link between MHT and dementia risk, according to a new review. Image Credit: SVPhilon/Getty Images
- A new analysis is easing long-standing fears about menopause hormone therapy and dementia.
- Reviewing data from more than a million women, researchers found MHT neither raises nor lowers dementia risk.
- Experts say that decisions about hormone therapy should focus on symptom relief and quality of life, not fear of cognitive decline.
Menopause hormone therapy is not associated with an increased risk of dementia in postmenopausal women, according to new research.
Menopause hormone therapy (MHT), previously known as hormone replacement therapy (HRT), is used to manage menopause symptoms, but for decades, women have been warned about serious associated risks.
These products carried the FDA’s most stringent boxed, or “black box,” warnings, citing potential complications including cardiovascular disease, cancer, and dementia.
Evidence now suggests that some of these concerns were likely overstated.
In a major about-face, the Food and Drug Administration (FDA) removed its black box warning labels on MHT products in November of last year.
“We are returning to evidence-based medicine and giving women control over their health again,” Health and Human Services Secretary Robert F. Kennedy Jr. said in a statement.
But the strongest signal of that shift may be coming not from regulators, but from the data, or the lack thereof.
In a new meta-analysis commissioned by the World Health Organization (WHO) that included health data from more than a million women, researchers found that MHT neither increased nor decreased dementia risk. The study was recently published in The Lancet Healthy Longevity.
“The World Health Organisation currently provides no guidance on MHT and dementia risk, leaving a critical gap for women, clinicians, and policymakers. Our work will help inform upcoming WHO guidelines on reducing the risk of cognitive decline and dementia,” Melissa Melville, a PhD Candidate and Ageing Researcher in the Department of Clinical Health Psychology at the University College London and first author of the study, told Healthline.
Melville stressed that the work’s importance is twofold: for clinicians, there is an urgent need for higher-quality research; for patients, decisions about MHT should be guided by symptoms and well-established benefits and risks.
Hormone therapy’s controversial, complicated history
The history of MHT is both complex and controversial. The practice began in the 1960s and peaked in the United States in the 1990s.
However, in 2002, results from the Women’s Health Initiative (WHI), the first and only large randomized controlled trial of MHT, suggested that the risks outweighed the benefits.
Participants in the study had an increased risk of breast cancer, stroke, pulmonary embolism, and heart attack. Following the publication of these results, MHT therapy declined by 45%.
A subgroup study known as the Women’s Health Initiative Memory Study (WHIMS) later published findings on dementia and Alzheimer’s disease among women taking MHT. The study reported a substantially increased risk of dementia and overall cognitive decline.
That study alone effectively cemented the perception that MHT increased dementia risk and had a chilling effect on both patient use and subsequent research.
“A lot of other research was halted at that point, which led to
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