Short-term menopausal hormone therapy shows no long-term cognitive effects

According to a study published on November 21, short-term menopausal hormone therapy (MHT) had no long-term cognitive effects when given to early postmenopausal women.^st in the open access journal PLOS medicine by Carey Gleason from the University of Wisconsin-Madison, USA, and colleagues.

Although MHT can provide relief from the challenging symptoms of menopause, many women and doctors are hesitant to start MHT due to safety concerns. Previous research has linked a form of hormone therapy to mild cognitive impairment and dementia in women over age 65, prompting research into the importance of age and timing of therapy for cognitive impairment. Other studies have suggested that transdermal estrogen may have long-term cognitive benefits.

In the Kronos Early Estrogen Prevention Study (KEEPS), early postmenopausal women with good cardiovascular health were randomized to receive one of two types of MHT (oral or transdermal estrogen) or placebo. At the end of the four years, no cognitive benefit or harm was seen in those who received MHT compared to the placebo group. However, the long-term cognitive effects of MHT are still under-researched.

In this new follow-up study – the KEEPS Continuation Study – researchers revisited participants nearly a decade later to repeat a series of cognitive tests. Among 275 women, although MHT failed to protect against cognitive decline in the short term, it also had no negative long-term cognitive impact.

These findings may reassure women considering MHT while adding to the growing body of research supporting the importance of timing for MHT. More research is needed to investigate whether these results are generalizable to women at higher cardiovascular risk.

The authors add: “For menopausal women and the healthcare providers who care for them, obtaining direct, clear and evidence-based information about menopausal hormone therapy is a challenge. And they need data to guide their decisions .”