Study Shows Hormone Therapy Lowers Alzheimer’s Risk If You Start It Early
Hormone levels change a lot after menopause. Most notably, estrogen levels fall sharply and remain at a low baseline level. Estrogen is a protective hormone1, and this drop of estrogen leaves women more vulnerable to chronic disease, including Alzheimer’s disease.
While lifestyle factors (like regular exercise and following an anti-inflammatory diet) can help counter this risk, a first-of-its-kind meta-analysis suggests that hormone therapy can help decrease the risk of Alzheimer's if it’s started within a certain time frame. Here’s what you need to know.
About the study
For this study, researchers examined how the timing of hormone replacement therapy impacts the likelihood of developing Alzheimer's disease.
Hormone therapy refers to medical treatments that provide your body (most commonly through pills or patches placed on the skin) with some of the key sex hormones that decline after menopause.
Estrogen hormone therapy is most typically started after menopause (or a full 12 months after a woman’s last menstrual cycle) when the ovaries are no longer producing the hormone.
So, researchers reviewed more than 50 studies, looking at who began HRT at different ages after menopause, the type of hormone used (estrogen alone, estrogen with progestin, or estrogen with selective estrogen receptor modulators) compared to a placebo, and how therapy influenced brain changes seen on scans and lab tests.
Timing of hormone therapy & Alzheimer’s risk
Results showed that timing is everything.
Women who started HRT within five years after menopause reduced their risk of developing Alzheimer’s by 20–32%. But starting therapy after age 65 increased the risk by 38%, particularly when therapy included progestin.
Why the difference? Well, as we mentioned earlier, estrogen offers a lot of protective properties, including protecting the brain via calming inflammation and helping brain cells communicate, all of which are protective against Alzheimer’s disease.
However, estrogen can also be inflammatory under certain conditions. And adding estrogen when signs of Alzheimer's disease are already present may spur even more inflammation in the brain. This is why the researchers were particularly interested in knowing when women start treatment.
What this means for you
While these results are promising, research in this area is still ongoing. In fact, this study still has to undergo the peer-reviewed process for publishing. The results were recently presented at the American Neurological Association’s annual meeting.
But if you’re a woman in your 40s or early 50s, it’s a good time to talk to your healthcare provider about hormone therapy. Not only can some hormone treatments help treat menopause symptoms like hot flashes, mood swings, and sleep disturbances, they can also support your longevity.
So here’s what you can do now:
- Talk to your doctor early: If you’re in your 40s or early 50s, it’s time to talk to your healthcare provider and discuss whether hormone therapy is right for you.
- Review your therapy options: Hormone therapy is extremely personalized. While estrogen therapy is typically administered after menopause, your healthcare provider may recommend other options during peri-menopause. There are also various delivery methods (including pills, patches, and creams). One form may better suit your needs than others.
- Seek out more information: Managing peri- and post-menopause is no easy feat. But understanding exactly what your body is going though can help you manage the changes. This is a great resource for research-backed support.
The takeaway
Estrogen plays a key role in protecting women’s brains, and hormone therapy can help offset the drop that happens after menopause. Starting hormone therapy within five years of menopause may lower Alzheimer’s risk, while waiting until after 65 could increase it.
The key is to have early, informed conversations with your doctor whether this treatment is right for you.