Hormone therapy and dementia risk: What you need to know
Hormone therapy for menopausal symptoms has been a topic of debate when it comes to brain health. Recent studies have shed new light on how it might affect a woman’s risk of developing dementia later in life.
A study published in March 2025 found that women who used hormone therapy after age 70 showed faster accumulation of tau protein in certain brain regions[1][8]. Tau buildup is associated with Alzheimer’s disease. This suggests that starting hormone therapy later in life could potentially increase dementia risk.
However, the picture is different for younger women. The same study found that women under 70 who used hormone therapy had no significant increase in tau accumulation[1][8]. Some research even hints that hormone therapy started close to menopause might have protective effects on the brain[7].
The timing of when hormone therapy is started seems to be crucial. Current guidelines recommend using hormone therapy within 10 years of menopause onset[10]. Starting earlier appears to be safer and potentially beneficial for brain health.
It’s not just about age, though. The type of hormone therapy matters too. Some studies indicate that estrogen alone may be safer for the brain than combined estrogen-progestin therapy[7].
Interestingly, hormone therapy might help with some brain-related menopause symptoms. Women who used hormone therapy reported fewer mild behavioral impairment symptoms, which are potential early signs of dementia[12].
The relationship between hormone therapy and dementia risk is complex. While later use might increase risk, earlier use could be protective. Factors like a woman’s age, time since menopause, and type of hormone therapy all play a role.
It’s important to remember that hormone therapy decisions should be individualized. Women should discuss their specific situation, including their dementia risk factors, with their healthcare provider. The goal is to balance the benefits of managing menopause symptoms with potential long-term risks.
Researchers are still working to fully understand how hormone therapy affects brain health. Future studies will likely provide more detailed guidance on how to optimize hormone therapy use for both symptom relief and long-term brain health.
