Hormones and Brain Health: Examining the Link Between HRT and Alzheimer’s

As summer comes to an end, I’m excited about the fresh start that fall brings – a chance to hit the reset button and reprioritize our goals for the rest of the year. This month, we’re focusing on Alzheimer’s and Brain health. I’d like to shed light on a topic that’s stirring discussions in the medical community: The Intricate Relationship Between Hormone Replacement Therapy (HRT) and Alzheimer’s disease and Dementia. Amidst the mix of confusing research and conflicting news, let’s break down what we’re certain about, what’s still a mystery, and how to approach this complex subject with an informed perspective.


What is Alzheimer’s Disease and Dementia?

What We Know for Certain:


What Remains to Be Clarified

  1. “Critical Window” theory suggests potential benefits of estrogen if administered early in menopause, while treatment outside the 10-year window of menopause could cause increased risk of Alzheimer’s.
  2. “Healthy-cell bias” theory proposes benefits in the presence of healthy brain tissue. 

However, neither theory has been substantiated through randomized clinical trials (3,9).

Considerations for the Future

To Recap:

The intricacies of how HRT interacts with Alzheimer’s risk are still unfolding. The interplay between hormones, diabetes, and heart health adds another layer to this intricate puzzle. As with any medical decision, a balanced assessment of risks and benefits is paramount. The NAMS guidelines (2022) suggest that the risk increase associated with Estrogen or Estrogen/Progestogen therapy (regardless of formulation) is rare (<10/10,000). These guidelines also highlight decreased all-cause mortality, fractures, diabetes, and breast cancer among women aged 60 and under receiving HRT (9). In men, studies of Testosterone Replacement Therapy have shown improved cognition and memory, as well as a reduction in risk of Alzheimer’s disease (1,5,10).

In my perspective, carefully optimizing hormones under the guidance of a knowledgeable healthcare professional can offer numerous benefits. While prevention hasn’t been explicitly endorsed, I believe that adopting a holistic approach that encompasses exercise, sleep, a balanced diet, and hormonal therapy when indicated, can contribute to lowering individual risk. I hope future studies will investigate specific formulations, ideally bioidenticals, and their relationship with cognitive decline, dementia and Alzheimer’s disease. Although causation remains complex, in my opinion, the disparity between men and women in the development of Alzheimer’s development hints at a compelling hormonal link. I hope future research explores this link and how we could harness the power of hormones in the prevention or management of cognitive decline.

If you’re curious about how hormone optimization could impact your health and wellness, I’d love for you to reach out! Check out our website and my Instagram page for more information!

And book a complimentary 15-minute consultation with me – I’d love to explore this path with you 😊

Shelby Sheppard
Nurse Practitioner

Follow us @hormone_optimization

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