Women who are treated with hormones in connection with menopause may have an increased risk of suffering from dementia diseases such as Alzheimer’s, according to a Danish study. But a Swedish expert sees no cause for concern for those who take hormones today.
It is researchers in Denmark who analyzed data on women who received the latter treatment and compared it with women who did not receive the treatment. In total, they have used data on roughly 5,600 women with a diagnosis of dementia and 55,900 women without. All were between 50 and 60 in 2000.
The results, which are published in the scientific journal BMJ, indicate that those who received estrogen-progestagen treatment had a 24 percent increased risk of developing dementia and Alzheimer’s compared to those who did not receive such treatment.
– These results are in line with other similar studies on hormone therapy and dementia and it provides a piece of the puzzle in a complex issue, says Angelica Lindén Hirschberg and senior physician at Karolinska University Hospital and professor of gynecology.
No definite causal relationship
But she points out that it is important to know that a study based on data from registers can never determine whether it is the hormone treatment that causes the increased risk seen. There may be other differences which mean that the women who were treated had an increased risk of developing dementia.
– Furthermore, these are women who were treated in the 1990s. Back then, there were different medicines than the ones we have today. Now many people in Sweden receive their hormones via patches and IUDs, which do not have the same effect on the system as the tablets that were usually given before, she says.
In the study, most of the women received estrogen in combination with synthetic corpus luteum hormone. Today, more and more people receive estrogen and bioidentical corpus luteum hormone in the form of progesterone.
– We have more and more data showing that the synthetic progestin is the culprit in the drama, says Angelica Lindén Hirschberg.
“Do not stop”
On average, the women in the study started their treatment at the age of 53 and they were treated for just under four years. The greatest increase in risk was seen after 12 years of treatment, when it was 74 percent higher than in the control group.
– We only recommend that you treat as long as you have symptoms, usually. Women who enter menopause early, before the age of 45, have an increased risk of dementia, and for them hormone therapy could even reduce the risk of dementia.
Menopausal symptoms affect around 75 percent of all women between the ages of 45 and 60. About a third suffer from such serious problems that they want treatment. The most common today is a combination of the hormones estrogen and progestogen or bioidentical progesterone.
According to Angelica Lindén Hirschberg, there is no reason for those who take hormones for menopausal symptoms to stop based on the new study.
– Because there are other medicines that are used today and because it is a registry study that cannot show a causal relationship, you should not stop because of concerns about dementia, she says.
THE FACTS The menopause
At menopause, one or more of the following symptoms may occur:
Hot flashes, this means you suddenly feel very hot. You can also freeze, this is called cold storage.
Sudden sweating, often associated with a hot flush.
Rapid changes in mood, feelings of low mood or being unwell.
Sleep problems, you may have both difficulty falling asleep and waking up during the night.
Dry mucous membranes, especially in the vagina but also in the eyes, nose and throat. Dry mucous membranes can make it itch and sting.
Urinary tract problems, for example that you often feel the need to urinate or that it stings when you urinate. It can also leak urine when you need to pee or when you cough or sneeze.
The body’s fat distribution changes in menopause and you may gain more fat around the waist. The risk of getting high levels of blood fats also increases.
Menopausal symptoms can be treated with drugs that contain estrogen. Estrogen is almost always used together with corpus luteum hormone. The corpus luteum hormone found in medicines is either natural or artificial.
Estrogen and progesterone or progestin are most often used together, but progesterone and progestin can be dosed in different ways.
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