Hormone therapy usually used to deal with the discomforts of menopause has been linked to an increased risk of developing dementia and Alzheimer’s: up to 74% more. This is revealed by a study conducted by Nelson Pourhadi dell’University of Copenhagen and published on British Medical Journal.
Tablets containing estrogens or combinations of estrogens and progestogens, skin patches, creams and gels. All those products that are part of the symptom relief process menopause (hot flashes, night sweats, muscle aches, anxiety, insomnia, etc.) they can haveso, side effects very serious for women’s psychological health. Especially if hired for more than a year.
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The results of the Danish study confirm what has already been observed since Women’s Health Initiative Memory Studythe largest clinical study on the correlation between hormone therapies, dementia and Alzheimer’s, published in 2005 in the Lancet.
However, that study lacked reliable data on the effect of short-term use, and of different treatment regimens, on the risk of dementia.
To fill these gaps, Danish researchers sought to verify the association between the use of combined estrogen and progestogen therapy and the development of dementia based on the type of hormone treatment, duration of use, and age of hiring.
The statistical crossing
Drawing on data from the Danish national registry, they identified 5,589 dementia cases and 55,890 dementia-free controls, from a population of all Danish women of age
aged between 50 and 60 in 2000. Prior to diagnosis, 1,782 (32%) cases and 16,154 (29%) controls had received estrogen-progestogen therapy starting at a mean age of 53 years. The mean duration of use was 3.8 years for women who later developed dementia and 3.6 years for the others.
The results show that women who received estrogen-progestogen therapy had a 24% higher risk of developing dementia and Alzheimer’s disease compared to treatment-naive patients. Risk that increased in cases of prolonged use: from 21% more for one year or less to 74% for more than 12 years of use.
The increase in the rate of dementia was similar between continuous treatment regimens (oestrogens and progestogens taken daily) and cyclic (estrogens and progestins taken daily for 10-14 days a month). The use of progestogen-only and vaginal estrogen-only therapy has not been associated with the development of dementia.
The impact of the Danish study
The British Medical Journal itself published an editorial together with the scientific article, in which readers are warned that the research results must be analyzed with due caution.
No matter how accurate the statistical research is, in fact, it is still a study observational: does not establish cause-effect links, but simply highlights an association that could also be due to different causes. In fact, as the leaker reports Barbara Gallavotti are “Facts to Understand“, portal of the Museum of Science and Technology of Milan, it cannot be excluded that hormonal therapy is mainly used by women with heavier manifestations of menopause, connected to vasomotor problems, such as, for example, sudden sensations of heat or excessive night sweats. It is possible, therefore, that it is precisely these symptoms that are connected with the possibility of developing dementia, especially considering that the Copenhagen researchers were unable to isolate cases of dementia connected to vascular causes from those with different origins.
If this were the case, hormone therapy would not be a direct cause of the increased risk of dementia, but only a consequence of it. Furthermore, not all forms of replacement therapy were associated with a greater risk of dementia: as Prof. Andrea Lenzi (Sapienza University of Rome), the therapies used today to treat menopause are different from those prescribed in 2000, taken by the people on whom the Danish study focused. Their side effects, therefore, may be quite different from those of current treatments. For this reason, to date, the Danish study just published cannot yet represent a sufficient reason to modify the therapeutic pathways currently in use. More confirmations will be needed.