Can hormone replacement therapy in women increase the risk of dementia?

In this study, the quantity and frequency of nocturnal hot flashes, associated with excessive sweating and sleep disturbances, were identified as highly concerning factors influencing the development of dementia.. This point becomes extremely important because among the many symptoms associated with menopause, hot flashes, because they are so common, tend to be greatly underestimated.

To complete the scenario of this large number of controversy, another group of researchers, at a very scientific level, in 2021, conducted a study that included 380,000 women who were already in the menopausal stage and had symptoms associated with this stage. In this group, the overall effect of hormone replacement therapy was considered positive, with lower rates of dementia, i.e. a situation quite opposite to the observations made by the other studies discussed previously.

Given this division of positions, what is the question of the possible association between hormone replacement during menopause and a higher risk of dementia?

There is nothing better than to showcase some of the weaknesses of this research, and to reiterate the need to continue investigating and maintaining hormone replacement therapy as something viable when well individualized and with well-estimated risks. There are three weaknesses that deserve deep thought:

Fragility 1

People, in this case menopausal women, may have a genetic predisposition to a range of conditions and diseases. Obviously, the weight of genetic factors may be difficult to measure, but it can never be excluded from any risk analysis. Genetic testing could be a possible solution and make the power of genetics less abstract.

Fragility 2

Because there are countless types of hormone replacement, each with its own formulation and dose distribution, there is no absolute certainty as to which combination(s) pose the greatest risk. Therefore, there is a gap that needs further investigation and correlation.

Fragility 3