Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Beaker on July 07, 2023, 11:57:49 AM
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https://www.bmj.com/content/381/bmj-2022-072770
This article just caught my eye.
It's positive that there is no causal link proven between HRT and dementia but there does seem to be a definite association between the two.
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Noticed it said vaginal estrogen didn't have the risk.
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I scanned this yesterday. Dismissed it. Not enough Research ......... ;)
Humans are full of hormones. MayB they are 1 of the reasons ??
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'only conjugated oestrogens were examined, not oestradiol, which is the leading oestrogen contained in contemporary menopausal hormone therapy products.'
Think these are the horse p*ss ones? So not relevant to anyone using transdermal or newer oral oestrogen?
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txn. was this in the Telegraphy this week?
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Interesting!
I was always thinking that using HRT actually REDUCED your chances of dementia? ::)
In any case, one must weigh up the plusses and minuses of using HRT. There are many benefits beside relieving most of the symptoms of menopause due to low oestrogen. (Eg. bone heath, some protection from cardio vascular events- and I DID think, some protection from dementia).
It's a personal decision we must all make.
Argh. :-\
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I do wish they'd stop these scare stories
Estradiol: Bedol®; Elleste-Solo®; Estraderm®; Estradot®; Evorel®; FemSeven®; Nuvelle®; Oestrogel®; Progynova®; Sandrena®; Zumenon®;
Conjugated oestrogens: Premarin®
So unless you're using Premarin you're NOT at higher risk of dementia. In fact, probably the opposite. There is a theory that estrodial actually protects against it though I don't think it's been proven yet.
No doubt there'll be more gps reading the article and frightening women against hrt (again).
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We must stand our ground.
I hate that dementia is classed as alzhiemers, two different conditions. The latter cannot be diagnosed until PM although scans may show changes.
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Great comments, thank you everyone
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We must stand our ground.
I hate that dementia is classed as alzhiemers, two different conditions. The latter cannot be diagnosed until PM although scans may show changes.
Alzheimer's is a dementia but just 1 of many types. The most well known type.
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Yes I understand that Alzheimer's is one type of Dementia.
And I thought that estrogen protects against dementia, osteoporosis and heart attack. Now I am confused. :(
I wonder why only the one from horses' urine increases the risk of Alzheimer's.
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This study was not about the effect of Premarin on dementia - but that study (the controversial Women's Health Initiative trials that led to a massive fall in women using HRT) was quoted as being one of the few actual trials that demonstrated a link, even though the study and conclusions were flawed and cannot be generalised to the conclusion that "HRT causes dementia".
Re the study highlighted by Beaker - you might want to see this brief statement by the British Menopause Society, which links to a detailed woman's hour discussion of the study on 29 June: https://thebms.org.uk/2023/07/radio-4-womans-hour-hrt-and-the-risk-of-dementia/.
I haven't really scrutinised the study in detail - just skimmed over it, and anyway my statistics experience was in the dim and distant past but the main things I took away from it were the same as what you said Beaker: the conclusion here:
" Further studies are warranted to determine whether these findings represent an actual effect of menopausal hormone therapy on dementia risk, or whether they reflect an underlying predisposition in women in need of these treatments"
... and that the study does NOT demonstrate a causal link between HRT use and dementia because it is an OBSERVATIONAL study (retrospectively analysing existing data gathered for other reasons) rather than PLACEBO CONTROLLED TRIAL (actual experimental trials designed to answer specific questions).
Even given these conclusions, as far as I could see the study had limitations in that:
1 There was no distinction between oral and transdermal HRTpreparations (although all the HRT types studied were with estradiol, and NOT Premarin - at least that I could see from the Table in the paper).
2 The study did not look at progesterone - maybe because at the time it was not commonly used as part of HRT
Interestingly in the Woman's Hour discussion, the woman interviewed, Professor Pauline Maki, said the whole issue was confusing because studies have shown that those who suffer from vasomotor symptoms were more likely to suffer cognitive and memory problems, and that ?trials had shown a positive effect on women who take HRT, on memory and cognitive stuff. Didn't quite catch all of that - towards the end of the discussion and whether these were from trials or other observational studies. She emphasised the need for further trials...
Also the study, I think showed that dementia onset is long after HRT use so it is not a straightforward link (association) anyway, and is a complex issue.
The long term effects of HRT on all sorts of measures will continue to raise all sorts of issues and especially as there is so much to study - but to me the bottom line is, if we are going to spend up to half our lives in a post-menopausal state (eg women who reach menopause at 45 and live to age 90), we have to balance potential risks that need further study, with quality of life, and other proven health benefits....
Please correct me if I'm wrong on any of this as I said I haven't looked or listened in detail....
Hurdity x
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'only conjugated oestrogens were examined, not oestradiol, which is the leading oestrogen contained in contemporary menopausal hormone therapy products.'
Think these are the horse p*ss ones? So not relevant to anyone using transdermal or newer oral oestrogen?
I think that quote is talking about a previous study that only used conjugated oestrogen in 2003.
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....as I said!
Hurdity x
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I'm shocked because I was under the impression dementia risk was reduced by HRT.
That could still be the case of course, correlation isn't causation after all.
I wonder if women who have a difficult menopause really are already more predisposed to dementia? It's plausible that a weak link internally could cause both problems in the same person.
Then HRT could still be protective, if they follow forward, women who have vasomotor symptoms, to see if they are more likely to develop dementia, then see if the ones on HRT do better or worse, that would tell us more.
Thanks Beaker for the info and to Hurdity for explaining it so well!
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....as I said!
Hurdity x
;D ;D ;D Indeed, I hadn't read that far yet!
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;D
Sorry my posts are often long!!!
Hurdity x
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;D
Sorry my posts are often long!!!
Hurdity x
As mine can be too, yours are better informed though and much appreciated xx