Estradiol-Based Hormone Therapy May Influence Cognitive Performance

Strategic Insights -

A recent study published in Neurology, the medical journal of the American Academy of Neurology, has found that the type of estradiol-based hormone therapy used during and after menopause may be associated with differences in memory performance. The study, which included 7,251 cognitively healthy postmenopausal participants, found that those using hormone patches or gels had better episodic memory, while those taking hormone pills had better prospective memory.

Key Takeaways:

  • The study found that hormone patches or gels were associated with better episodic memory, while hormone pills were associated with better prospective memory in postmenopausal women.
  • The study included 7,251 cognitively healthy postmenopausal participants from the Canadian Longitudinal Study of Aging, with an average age of 61 and an average age of menopause of 51.
  • The study found that earlier menopause was linked to lower scores across all areas of memory and thinking, with the strongest association found in executive function in people with four or more children and those carrying the APOE e4 gene variant.
  • Participants who used transdermal estradiol had better scores on episodic memory tests than those who never used hormone therapy, with an average difference of a third of a standard deviation.
  • Those who took estradiol pills demonstrated better scores on prospective memory than those who never used hormone therapy, with an average difference of a third of a standard deviation.
  • The study's findings suggest that the type of estradiol therapy matters, with different forms linked to different types of memory.
  • The study had a limitation of most participants being white and having higher incomes, which may affect the generalizability of the findings to other racial, ethnic, or socioeconomic backgrounds.

Statistics:

  • 7,251 participants were included in the study from the Canadian Longitudinal Study of Aging.
  • The average age of the participants was 61, and the average age of menopause was 51.
  • 4% of participants used transdermal estradiol in the form of patches or gels, creams, or tablets, while 2% took it as pills.
  • The remaining 94% of participants did not use hormone therapy.
  • The average difference in scores on episodic memory tests between participants using transdermal estradiol and those who never used hormone therapy was a third of a standard deviation.
  • The average difference in scores on prospective memory tests between participants taking estradiol pills and those who never used hormone therapy was a third of a standard deviation.

Sources:

  • [1] Galea, L. A. M. (2025, August 27). Hormone therapy and cognitive performance in postmenopausal women. Neurology, 85(11), 983-991.
  • [2] Brain and Life. (n.d.). Brain Health. Retrieved from
  • [3] American Academy of Neurology. (n.d.). About the American Academy of Neurology. Retrieved from