Hormone replacement therapy (HRT) has been a cornerstone in managing menopause related symptoms. Over the last few years, there is some research on it’s potential in reducing the risk or even delaying the onset of Alzheimer’s disease. Estrogen plays a vital role in brain function. It supports memory, cognition, and even mood regulation. As women approach menopause, the natural decline in estrogen may accelerate brain aging, possibly increasing vulnerability to neurodegenerative conditions like Alzheimer’s. This has had researchers wonder whether HRT can be used to preserve cognitive function.
There have been a few research papers which have suggested that early initiation of HRT can possibly reduce risk of Alzheimer’s. They suggest that there is a window period, that is within 10 years of menopause, where HRT if started can reduce the risk by reducing inflammation, promoting synaptic growth, and enhancing cerebral blood flow.
While HRT has its benefits, it needs to be understood that there are risks especially in patients with hormone receptor breast cancer. In such patients, non-hormonal medication or localised therapies like estrogen creams or rings maybe more beneficial.
HRT treatment needs to be individualised. The correct selection of patient needs to be done and that can be done by your doctor. HRT can get both relief from menopausal symptoms and long-term cognitive benefits. In addition, sometimes a multi-disciplinary approach maybe required. It’s also essential to consider factors like:
Family history of dementia
Cardiovascular risk
Type, dose, and delivery method of hormones (oral vs. transdermal)
Age at initiation
In today’s era of precision medicine, women deserve nuanced, evidence-based guidance—not fear or blanket restrictions. Hormone therapy can be a powerful ally, but only when used thoughtfully, and with awareness of both its promise and its limits.
Dr. Rohan Palshetkar is consultant IVF specialist at Bloom IVF and Palshetkar Patil Nursing Home, Mumbai.