MHT Myths Busted: What You Need to Know for Brain Aging

Early findings from the Women's Health Initiative in the early 2000s raised concerns about menopause hormone therapy (MHT), suggesting increased risks for heart disease, stroke, and cancer. However, subsequent re-analysis of this data has refined understanding, indicating that for many women, MHT can be safely prescribed around menopause to manage symptoms, with benefits often outweighing risks.

The critical window hypothesis highlights that initiating MHT during the menopausal transition may support brain health, whereas starting it years later could be linked to cognitive decline. Recent studies suggest varied outcomes, with some women experiencing cognitive benefits, while others see no negative impact. However, later MHT initiation has been associated with increased tau protein buildup, a marker for Alzheimer's disease.

Furthermore, the type and delivery method of MHT significantly influence its effects. Newer forms like 17-beta estradiol are often preferred over older combinations, and transdermal methods (patches, gels) may carry fewer risks than oral pills by bypassing the liver. MHT is not a dementia prevention strategy but can support well-being and potentially brain health for those who struggle with menopause symptoms.