HRT Might Harm Some Women

Boston – According to a study conducted by the National Institute on Aging, the popular treatment for women experiencing menopause may actually cause their brain to shrink in two key areas.

The thinking and memory locations in the brain, the frontal lobe and the hippocampus, show signs of decreasing in size after hormonal replacement therapy (HRT) in women 65 or older. Any woman seeing a headline like “Study: Hormone Replacement Therapy Might Shrink Brains” after the scare of 2002 regarding heart and stroke problems is probably wondering if the therapy is worth it.

However, studies have found that this shrinkage in these two critical areas seem to be limited to women who are over 65 and already experiencing symptoms of dementia. According to Susan M. Resnick of the National Institute on Aging and lead author of the paper, “The negative effects were most evident in women who already may have had some memory problems before using hormone therapy. . . so it suggests that hormone therapy may be accelerating processes that have already begun.”

Although hormone replacement therapy has lost some popularity since studies have suggested a higher risk of heart and stroke problems, this new study indicates the stroke and heart ailments may be affected more by these changes in the brain than vascular changes, signaling good news to younger women on HRT. The healthier the brain, the fewer changes due to HRT therapy, however, Resnick further advises that HRT should be initiated for the shortest period of time at the lowest possible dose to mitigate any problems with the therapy.

Evidence shows that hormone replacement therapy has been beneficial for younger women in improving mental clarity and might prevent the onset of Alzheimer’s disease. According to Dr. Pauline Maki from the University of Illinois at Chicago, this could be attributed to “the healthy cell bias of estrogen”, meaning that estrogen is good for healthy cells, and bad for unhealthy ones.

Many factors need to be taken into consideration when thinking about hormone replacement therapy. There seems to be a clear indication by the current study indicating hormone replacement therapy might shrink brains that HRT is best suited to women under 65, and certainly contraindicated for women with established problems with dementia or decreased brain function. The best advice seems to be to follow the current guidelines as set by the FDA and start HRT as soon as indicated at the lowest dose for the shortest period of time to maximize the benefits.

Image source: Mayo Foundation