Neurology journal, August 2016

The role of HRT in improving cognitive abilities such as verbal memory continues to be debated, with lack of clarity around the role of menopausal estrogen lack, and hence the role of hormone replacement, along with the role of simply ageing. Mention has been made of a possible “window of opportunity” whereby the use of HRT in the early years after the menopause may be protective. However, recent publication of a randomised trial questions the role of estrogen.

567 women who were within six years of the menopause, or were 10 or more years post menopause, were randomly assigned to oral estradiol or placebo, with those who had not had a hysterectomy receiving oral estradiol plus progesterone or placebo. Any change in tests assessing verbal memory was assessed at 2.5 and 5 years.

Results showed no difference in verbal memory between those who received HRT and those who received placebo, whether HRT was started within six years of the menopause or later. The authors concluded that estradiol provided neither benefit or harm in respect of the cognitive abilities tested regardless of time since menopause.

Ref Henderson VW, St John JA, Hodis HN et al. Cognitive effects of estradiol after menopause: A randomized trial of the timing hypothesis. Neurology, 2016 Aug 16;87(7):699-708