WLBT 3 - Jackson, MS: HRT & Memory

HRT & Memory

More bad news about hormone replacement therapy!  Last summer, millions of menopausal women stopped the therapy after a major study identified a link between combination therapy and breast cancer and heart disease. Still some women held out, hoping the drug would protect them from memory problems like dementia. But research out today shows just the opposite is true.

The four year study of more than four thousand women brings a resounding answer to one of the last big questions about hormone replacement therapy:  Does the combination estrogen - progestin help protect memory and prevent dementia as a woman ages? Dr. Sally Shumaker led the research. "What we found was the combination therapy doubled the risk of dementia compared to the women in the placebo group."

Disappointing news, especially for those women who were willing to risk a slight increase in their risk of breast cancer and heart disease, if hormone therapy could prevent dementia. Some studies had suggested a memory benefit, but the researchers say this is the first scientific look at the impact of the combination therapy on memory. Health experts note that while the findings may seem alarming, women need to put the risk in perspective.

Dr. Judith Salerno, of the National Institutes on Aging, says, "So on a population basis, it's double the risk, but for an individual woman, even those taking hormonal therapy, the risk remains quite low."

The resarchers now plan to follow the women in the study to see if the increased risk for dementia continues after stopping the therapy, but say the message for women is clear.  "The bottom line message, certainly for older women is there's no reason for them to be taking combination therapy any longer," says Dr. Shumaker.

A study testing the memory effects of estrogen alone is still underway, but scientists say this latest finding adds to the growing body of evidnce that hormone replacement therapy is not be the magic bullet women and doctors had hoped it would be. 

The study also found that the combination therapy did not protect against the development of mild cognitive impairment, or mci, a form of cognitive decline less severe than dementia. Researchers say they plan studies to figure out how hormone therapy may increase the risk of dementia. There is some evidence that it may help trigger silent strokes in the brain.

The study is published in the Journal of the American Medical Association. Another study in the same journal confirms the risk of stroke in women who take hormone replacement therapy. In July 2002, all combination therapy components of the women's health initiative were halted when it was found that increased risk of breast cancer, heart disease, stroke, and blood clots among participating women on combined estrogen plus progestin therapy outweighed benefits for hip fractures and colorectal cancer.

The memory findings were reported by Whims principal investigator Sally S. Shumaker, ph.d., Wake Forest University School of Medicine, Winston-Salem, NC, and colleagues at the 39 sites involved in the Study in the Journal of the American Medical Association.

The memory substudy Whims was funded by Wyeth Pharmaceuticals, which manufactures Prempro, which it provided for use in the whi trials. The larger women's health initiative trials are supported by the National Heart, Lung, and Blood Institute (NHLBI) of the NIH.  The NIA has been involved in reviewing the current findings as the NIH's lead institute on age-related memory change and dementia.

If you have questions about hormone therapy and memory loss, talk with your physician. For more information, visit www.jama.com