Hormone therapy used during menopause does not seem to affect a woman’s cognitive abilities

THE QUESTION Hormone therapy carries serious cognitive risks for women older than 65. Might the development of memory and thinking problems also be an issue for younger women who take hormone therapy for a while to ease menopause symptoms?

THIS STUDY analyzed data on 1,326 post-menopausal women who had been randomly assigned to take hormone therapy or a placebo for an average of seven years, starting at age 50 to 55. Participants took either an estrogen-plus-progesterone combination or, if they had had a hysterectomy, estrogen alone. Standardized tests of memory and thinking skills, given about seven years after the women had stopped taking the medication and again a year later, revealed virtually no difference in cognitive abilities between those who had taken hormone therapy and those who had not. The researchers found no overall cognitive benefit or harm from the hormone therapy.

WHO MAY BE AFFECTED? Women who take or might consider taking hormone therapy for such menopause symptoms as hot flashes, night sweats and vaginal dryness, which usually develop around age 50. Though shown to relieve these symptoms and to help prevent osteoporosis, hormone therapy also increases the risk for breast cancer, heart disease and stroke. Experts generally suggest that women who take the medication do so at the lowest dosage and for the shortest time possible. Findings on its detrimental effect on cognition have been limited to older women, based on a study 10 years ago that found women 65 and older who were taking a specific type of combination therapy in hopes of maintaining or improving cognitive skills were twice as likely to develop dementia, including Alzheimer’s, as women who were not.

CAVEATS Women who took estrogen-only therapy scored slightly worse on verbal fluency tests, but the researchers said this might have been a chance finding.

FIND THIS STUDY June 24 online issue of JAMA Internal Medicine.

LEARN MORE ABOUT hormone replacement therapy at nia.nih.gov/health (click “publications,” then type “menopause” as keyword) and www.hormone.org (search for “menopausal hormone therapy”).

The research described in Quick Study comes from credible, peer-reviewed journals. Nonetheless, conclusive evidence about a treatment's effectiveness is rarely found in a single study. Anyone considering changing or beginning treatment of any kind should consult with a physician.