Women in early postmenopause often face the decision of whether to undergo menopausal hormone therapy (MHT) to manage their symptoms, and concerns over potential cognitive side effects can impact this choice considerably. Recently published research by Carey Gleason and colleagues from the University of Wisconsin-Madison explored the long-term cognitive effects of short-term MHT when initiated soon after menopause onset. The team’s investigation aimed to address whether MHT could offer any lasting cognitive benefits or if it might lead to mild cognitive impairment or dementia.
The Kronos Early Estrogen Prevention Study (KEEPS) served as the foundation for this critical research. KEEPS involved a group of women in early postmenopause with good cardiovascular health, who were randomized to receive either oral or transdermal estrogen MHT or a placebo for a duration of four years. In the initial evaluation phases, there were no observed cognitive benefits or detriments when comparing the MHT groups to the placebo group, which was somewhat reassuring. This preliminary outcome suggested that, at least in the short term, MHT was neither harmful nor particularly helpful in preventing cognitive declines among early postmenopausal women.
Insights from the KEEPS Continuation Study
To delve deeper into the long-term cognitive impacts of short-term MHT, researchers conducted a follow-up study known as the KEEPS Continuation Study. Participants from the original KEEPS study were invited back almost ten years later for cognitive re-evaluation. Of the 275 women who participated in this follow-up, the findings indicated that short-term MHT did not have any long-term negative cognitive effects. These results reassured both patients and healthcare providers that short-term hormone therapy treatments initiated soon after menopause do not pose significant risks to cognitive health ten years down the line.
However, the study also revealed that short-term MHT did not provide a protective benefit against cognitive decline, which some had hoped for based on earlier studies linking transdermal estrogen to potential cognitive advantages. Despite the lack of protective effects, the data still provided a crucial understanding that early postmenopausal MHT does not seem to impair cognitive functions in the long run. This insight is particularly valuable for women considering MHT as a therapeutic option for managing menopause symptoms, giving them confidence that such treatments won’t adversely affect their cognitive health in later years.
Implications and Future Research
These findings underscore the importance of ongoing research into the cognitive effects of menopausal hormone therapy. While short-term MHT initiated soon after menopause does not appear to pose long-term cognitive risks, it also does not offer protective benefits against cognitive decline. Future research should focus on identifying specific factors that might influence the cognitive outcomes of MHT and exploring alternative strategies for preserving cognitive health in postmenopausal women. Understanding the nuances of how hormone therapy interacts with brain health over time remains a critical area of study for enhancing the well-being of women during and after the menopausal transition.
