12/05/2025
REPOST: One question keeps coming up: Does menopause hormone therapy (MHT, formerly HRT) prevent Alzheimer’s disease?
There’s a lot of understandable confusion, so let’s take a calm, science-first look at what we actually know:
1️⃣ For women who experience early menopause, especially following surgery, starting estrogen therapy early on can support cognition, mood, and more. This is part of current professional guidelines.
2️⃣ The Women’s Health Initiative remains the only clinical trial that tested MHT for dementia prevention. It was done over 20 years ago, in women aged 65+. The trial showed an increased risk of dementia (not specifically Alzheimer’s) with oral conjugated equine estrogens (CEE) plus medroxyprogesterone acetate (MPA), and no significant change with estrogen alone. These results cannot be generalized to other formulations or to women starting therapy at midlife. (Or to Alzheimer’s, btw)
3️⃣ Preclinical research consistently shows benefits when MHT is initiated at the time of menopause, not decades later.
4️⃣ Pooled data from observational studies show that starting MHT in midlife, mostly estrogen only therapy, is associated with a lower risk of Alzheimer’s and dementia. That’s consistent with guidelines. Note-observational studies cannot prove cause and effect (this is very important!).
THEREFORE: We need to rigorously test whether MHT started in midlife can reduce
Alzheimer’s risk.
This is a real scientific question - open, urgent, and answerable with the right tools.
More science is coming. Specifically, CARE - designed and directed by - is a program dedicated to hormonal aging, menopause, and Alzheimer’s risk in women. It’s using state-of-the-art biomarkers, brain imaging, and multi-site datasets to rigorously test, among other things, whether hormonal interventions can reduce Alzheimer’s risk.
More answers, grounded in evidence, are on the way.
