The segment made some bold claims, suggesting that saying HRT lowers the risk of dementia is misleading—and even called it “a lie.” They also raised concerns about HRT causing blood clots, leaving many women confused and worried about its safety.
But is this really the full story? Is HRT as risky as they made it sound, or is there more to consider?
Let’s look at the facts and break down what the science actually says.
HRT and Dementia: What’s Really Going On?
The idea that HRT could be linked to dementia comes from the Women’s Health Initiative (WHI) study, published back in 2002. This study linked combined HRT (estrogen and progestin) to an increased risk of dementia in older women. But here’s the crucial detail—this study looked at women who started HRT later in life, many of them already in their 70s.
Timing Matters
More recent research paints a different picture:
Starting HRT Earlier: Women who start HRT during perimenopause or early menopause (within 10 years of their last menstrual period) actually show a reduced risk of dementia.
The Critical Window Hypothesis
The Critical Window Hypothesis suggests that estrogen has protective effects on the brain if started during perimenopause or early menopause, but it can have adverse effects if initiated later.
Here’s why:
Early Initiation: When started around the time of menopause, estrogen supports brain function by maintaining neural connections, reducing inflammation, and supporting blood flow to the brain.
Late Initiation: If started many years after menopause, estrogen may interact with an already aging brain, which might have existing amyloid plaques or vascular changes. In this context, estrogen can:
Promote Amyloid Deposition: Estrogen can potentially increase the buildup of beta-amyloid plaques, which are linked to Alzheimer’s disease.
Inflammation and Oxidative Stress: In an aged brain, estrogen might enhance inflammatory processes rather than reducing them.
Type of HRT Makes a Difference: Today’s body-identical hormones, like transdermal estrogen and micronized progesterone, don’t carry the same risks as older synthetic versions used in the WHI study.
What the ABC Interview Didn’t Mention
The interview didn’t address the importance of when HRT is started or the type of hormones used. Blanket statements about HRT and dementia are misleading without explaining these critical factors.
What About HRT and Blood Clots?
The link between HRT and blood clots is mostly related to oral synthetic estrogens, which were linked to a higher risk of blood clots in earlier studies. But not all forms of HRT are the same.
The Safer Option: Transdermal Estrogen
Transdermal estrogen (through the skin) doesn’t increase the risk of blood clots. This is because it bypasses the liver, avoiding the increase in clotting factors seen with oral estrogens.
Micronized progesterone, used in body-identical HRT, is also safe and does not raise the risk of blood clots.
Why the Confusion?
Older studies, like the WHI study, used synthetic oral estrogens and synthetic progestins, which do carry a higher risk of blood clots. But modern body-identical HRT options are much safer and don’t come with the same risks.
Why Does This Matter?
The way information is presented can have a big impact on women’s health decisions. Dementia and cardiovascular disease are major health concerns for menopausal women, and HRT, when used correctly, can actually reduce these risks.
Here’s What We Know:
HRT can reduce dementia risk if started at the right time and with the right type of hormones.
Transdermal estrogen and micronized progesterone don’t increase the risk of blood clots.
Personalized treatment is key—everyone’s health needs are different, so consulting with a menopause specialist is important.
The relationship between
Comments