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7. Memory, Mood & Menopause: How Estrogen Affects Your Brain

New research suggests that hormone replacement therapy (HRT), when started early, may not only ease menopause symptoms but also help reduce the risk of Alzheimer’s disease in women.

Inputs by: Dr. Rohan Palshetkar, Consultant IVF Specialist, Bloom IVF, Palshetkar Patil Nursing Home, Opera House

What is Hormone Replacement Therapy (HRT)?

Hormone Replacement Therapy (HRT) has long been used to manage menopause symptoms such as hot flashes, mood swings, and sleep disturbances. But new findings are shining light on a possible additional benefit—its potential role in reducing the risk of Alzheimer’s disease and slowing age-related cognitive decline in women.

Estrogen is more than just a reproductive hormone—it plays a crucial role in brain function, supporting memory, cognition, and emotional regulation. As estrogen levels drop during perimenopause and postmenopause, some studies suggest this hormonal shift may accelerate brain ageing, making women more vulnerable to neurodegenerative diseases like Alzheimer’s.

How does Hormone Replacement Therapy (HRT) benefit you?

Emerging research now points to a possible “window of opportunity”—typically within 10 years of menopause—when early initiation of HRT might lower the risk of Alzheimer’s. During this time, estrogen therapy may reduce brain inflammation, boost cerebral blood flow, and encourage synaptic growth, all of which are protective factors against cognitive decline.

That said, HRT is not suitable for everyone. Women with a history of hormone receptor-positive breast cancer may be advised against systemic hormone use. In such cases, non-hormonal alternatives or local estrogen therapy—like creams, vaginal tablets, or rings—may offer symptom relief without systemic risk.

A personalised approach to HRT is essential. Factors such as family history of dementia, cardiovascular health, the type of hormones used (e.g., bioidentical estrogen), method of delivery (oral vs. transdermal patches), and age at the time of initiation all play a critical role in determining its effectiveness and safety.

In the age of precision medicine, women deserve informed, evidence-backed guidance when it comes to managing their health. When used appropriately, hormone therapy for menopause may offer not just relief from uncomfortable symptoms but also long-term cognitive health benefits.

For the right patient, and under medical supervision, HRT may serve as both a symptom reliever and a brain protector. A multidisciplinary approach involving gynaecologists, neurologists, and primary care providers can help create the right care plan.