Does Menopausal Hormone Therapy Increase the Risk of Dementia?

Pavankumar Kamat


October 13, 2021


  • The use of menopausal hormone therapy was not associated with an overall increased risk of dementia, which was consistent across types of treatment and durations, age categories and times of therapy initiation.

  • However, the use of oestrogen-progestogen treatments for >5 years was associated with a slightly increased risk of Alzheimer’s disease (AD).

Why this matters

  • Findings will help policymakers, doctors and patients while making decisions about hormone therapy.

Study design

  • 2 nested case-control studies included 118,501 women with a primary diagnosis of dementia (age, ≥55 years) and 497,416 age-, general practice- and index date-matched control participants from the UK QResearch and Clinical Practice Research Datalink (1998-2020).

  • Funding: None.

Key results

  • Overall, 16,291 (14%) women with a diagnosis of dementia and 68,726 (14%) control participants had been exposed to menopausal hormone therapy more than 3 years before the index date.

  • After adjustment for confounders, the risk of dementia did not increase with the use of hormone therapy for (adjusted OR [aOR]; 95% CI):

    • oestrogen-only treatments (0.99; 0.96-1.02); and

    • oestrogen-progestogen treatments (1.00; 0.97-1.03).

  • In women aged younger than 80 years, exposure to oestrogen-only treatment for >10 years was associated with a lower risk of dementia (aOR, 0.85; 95% CI, 0.76-0.94; P=.003).

  • Women exposed to oestrogen-progestogen therapy for 5-9 years (aOR, 1.11; 95% CI, 1.04-1.20) and ≥10 years (aOR, 1.19; 95% CI, 1.06-1.33) had a slightly increased risk of AD.


  • Possibility of residual confounding bias.


Vinogradova Y, Dening T, Hippisley-Cox J, Taylor L, Moore M, Coupland C. Use of menopausal hormone therapy and risk of dementia: nested case-control studies using QResearch and CPRD databases. BMJ. 2021;374:n2182. doi: 10.1136/bmj.n2182. PMID: 34588168  View full text

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.