The decision to use hormone replacement therapy (HRT) after menopause
is complicated by conflicting data on its benefits, such as reducing risk
of dementia, and the increase in risk of endometrial and breast cancer, and
possibly ovarian cancer. In a prospective study of postmenopausal women followed
up for 14 years, Rodriguez and colleaguesArticle found that women who used estrogens
at baseline (1982) or within 15 years prior to baseline for 10 or more years
had higher death rates from ovarian cancer than never users. Geerlings and
colleaguesArticle, using data from a prospective study of postmenopausal women aged
55 or older, found that a longer reproductive period, as an indicator of long-term
exposure to endogenous estrogens, was not associated with a decreased risk
of dementia. LeBlanc and colleaguesArticle conducted a systematic review and meta-analysis
of studies on the relationship between HRT and the risk of cognitive decline
and dementia. HRT use was associated with improvement in some cognitive functions
among women who had symptoms of menopause, but not among asymptomatic women.
Risk of dementia appeared to be reduced among women who used HRT, but most
of the studies had methodological limitations.