Study ties estrogen-based menopausal hormone therapy to lower Alzheimer's risk
Women on regimens of estrogen-only menopausal hormone therapy are at reduced risk of Alzheimer's disease, a study by Stanford Medicine investigators has found. Because estrogen-only therapy is generally prescribed for women without a uterus, most of these users presumably had had hysterectomies.
Researchers at Stanford Medicine have discovered that women who use estrogen-only menopausal hormone therapy (MHT) are less likely to develop Alzheimer's disease. Estrogen-only therapy is typically prescribed to women who have had hysterectomies, as it avoids the side effects associated with using both estrogen and progesterone.
The study, published in Neurology, is the first to examine the relationship between MHT and reductions in Alzheimer's-related brain damage in autopsied brains. Alzheimer's disease is the most common cause of dementia, affecting more than two-thirds of patients.
The researchers analyzed data from two databases containing 21,462 participants. They examined 258 brain autopsies of women who had used estrogen-only MHT and compared them to 2,701 women who had not used any form of menopausal hormone therapy. The scientists measured the presence and location of Alzheimer's hallmarks, such as amyloid plaques and neurofibrillary tangles, in the brains of both groups.
They found that estrogen-only MHT users had a 39% lower risk of receiving a clinical diagnosis of dementia during their lifetimes and performed better on memory tests and in their overall ability to function independently.
While the study does not prove that estrogen-only MHT directly causes a reduction in Alzheimer's risk, it does suggest a protective effect. The researchers adjusted for various factors, such as age, genetic predisposition, and cardiovascular health, to ensure the results were not influenced by these variables. The findings are particularly relevant for about one-third of women of menopausal age, as many have undergone hysterectomies and may be prescribed estrogen-only therapy.
However, the study did not include data on women using estrogen-plus-progestin formulations or topical estrogen therapy, limiting the applicability of the results.
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