Does Hormone Replacement Therapy Cause Dementia?

by Deborah Maragopoulos FNP | Oct 4, 2023 | Menopause, Women's Health | 0 comments

Does Hormone Replacement Therapy cause dementia? Let's talk about it. 

There's been some hype in the media lately that hormone replacement therapy can contribute to dementia. Let's look at what the study really shows and whether it should affect our decision to use BHRT.

First of all the study looked at two groups who took combined hormone therapy for about the same length of time with the dementia group taking HRT for 3.8 years and the control group taking HRT 3.6 years. The researchers did not control in either group for women who might have had a family history of dementia.

What they found was:

  • There was no increased risk of dementia among women taking only progestin.
  • There was no risk of dementia in women taking only estrogen.
  • There was a small and statistically significant increase of combined menopausal hormone therapy among those with dementia - 31.9% of the dementia patients 31.9% had taken estrogen and progestin while in the those women who hadn't developed dementia only 28.9% took the combined menopausal hormone therapy. 

Now remember, when we're talking about combined menopausal hormone therapy using synthetic progestin, not progesterone, and pharmaceutical estrogen. 

These are not the same as bioidentical estradiol and progesterone, which we know are both neuroprotective and neuro-regenerative.

The new findings conflict with a 2005 study by Danish researchers who found that women who were given menopausal hormone replacement therapy for two to three years had a 64% decrease risk for cognitive impairment five to 15 years later compared to women who had only been taking placebos instead of hormones. 

There's no reason to be concerned about menopausal hormone therapy causing dementia.

If you have a family history of dementia or Alzheimer's, then doing some genetic counseling and talking with your health care provider about your particular issues, before making the decision to use hormone replacement therapy would be a great idea. 

If you're currently taking menopausal hormone replacement therapy, particularly bioidentical estradiol, estriol and progesterone, there's no research that shows that any of these combinations of hormones will increase the risk of dementia in menopausal women. 

In fact, it has been shown that utilizing these hormones during menopause can decrease the risk of dementia. In my book Menopause Action Plan™, I discuss the current research and recommendations regarding HRT for women with different risk factors. 

If you have any more questions, please join me in the Hormone Reboot Training.

Hormone Reboot Training
Resources:

Early postmenopausal hormone therapy may prevent cognitive impairment later in life; Yu Z Bagger et Al; Menopause; 2005

Frequently Asked Questions:

Can your hypothalamus cause weight gain?

Yes. The hypothalamus is the master regulator of metabolism, controlling how your body stores and burns energy through its signaling to the thyroid, adrenals, and pancreas. When the hypothalamus becomes dysregulated by chronic stress, poor sleep, inflammation, or blood sugar instability, it defends a higher weight "set point" — causing the body to hold onto fat regardless of diet or exercise. This makes hypothalamic dysfunction an upstream root cause of stubborn weight gain.


What is a weight set point and why won't mine move?

A weight set point is the body weight your hypothalamus works to defend, calibrated over time by stress, sleep, hormones, and inflammation. When you diet, the hypothalamus perceives scarcity and responds by slowing metabolism, increasing hunger hormones, and suppressing satiety signals to return you to that set point. This is why most people regain lost weight within two to five years of conventional dieting — the set point itself was never recalibrated, only temporarily overridden.


Why do I gain weight under stress even when I'm not eating more?

Chronic stress raises cortisol, which disrupts blood sugar regulation, promotes abdominal fat storage, and signals the hypothalamus that the body is under threat. In survival mode, the hypothalamus defends fat stores and slows metabolism — so weight can increase even without any change in calorie intake. The stress chemistry, not the food, is driving the weight gain, which is why stress reduction is essential to any lasting metabolic reset.


Why do I regain weight after stopping GLP-1 medications?

GLP-1 medications work peripherally on appetite and gastric signaling, but they do not address the underlying hypothalamic dysregulation that sets your defended weight. Because the hypothalamic set point is never recalibrated, the body resumes defending its original weight once the medication stops — leading to significant regain. Long-term success requires restoring hypothalamic regulation so the set point itself lowers, rather than relying on appetite suppression alone.


How long does it take to reset your metabolism?

Genuine metabolic recalibration takes a minimum of 90 days, because the hypothalamus needs consistent signals of safety and sufficiency before it will lower its defended set point. This differs from a diet, which produces temporary suppression the body quickly corrects. A 90-day reset typically moves through three phases: stabilizing stress chemistry (days 1–30), rebuilding metabolic efficiency (days 31–60), and lowering the weight set point (days 61–90).


Why does my thyroid feel slow even though my labs are "normal"?

Under chronic stress, the body converts thyroid hormone into reverse T3, which blocks active thyroid receptors and slows metabolism at the cellular level — even when standard lab values appear normal. This means you can experience genuine symptoms of slow metabolism, such as fatigue, cold intolerance, and brain fog, while your thyroid panel looks unremarkable. Addressing the upstream hypothalamic and stress signaling often improves thyroid conversion and symptoms.


Is stubborn weight gain a willpower problem?

No. Stubborn weight gain is a signaling problem, not a willpower problem. The hypothalamus governs weight through survival mechanisms that operate below conscious control — defending its set point by slowing metabolism and increasing hunger when it perceives threat. No amount of discipline can override this system; lasting change comes from restoring hypothalamic regulation through reduced stress, balanced blood sugar, restorative sleep, and targeted nutritional support.

About the Author - Deborah Maragopoulos FNP

Known as the Hormone Queen®️, I’ve made it my mission to help everyone - no matter their age - balance their hormones, and live the energy and joy their DNA and true destiny desires. See more about me my story here...

     

Last Updated: November 14, 2023

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