Challenging Menopause Hormone Therapy

     For one-third of their lives, women live in an estrogen-deprived state. The loss of this hormone can cause more than just damage to reproductive health, but the discovery of hormone therapy in recent years has opened up a new view to life after menopause. The debate that hormone therapy is dangerous has led to a decline in its use but recent research has challenged these ideas about the role of estrogen and progesterone beyond their use in reproductive functions. A recent article in The Times focused on hormone replacement therapy (HRT), where some doctors in the United Kingdom were being accused of prescribing over the recommended amount of estrogen (Spencer 2024). While past studies have highlighted some concerns about the risks of hormone therapy, this newer research suggests that the timing and duration of hormone loss in this state of a woman’s life is influential in what its effects might be. 

            The research conducted was done in rats and found that estrogen deficiency can make learning and cognitive function more difficult. The introduction of BDNF into these studies showed how brain activity improved. Estrogen was found to strengthen cognitive function, regulate spine density, and even increase neurotrophic expression, which all lead to the conclusion that estrogen is neuroprotective by activating ERK/MAPK pathways. This then raised the question of whether progesterone might also play a similar protective role, which indeed did. 

            The article also highlights an important topic where many women struggle to access adequate treatment, with the fear of outdated risks deterring doctors from prescribing HRT, which then leaves many women to suffer from debilitating symptoms without relief for years. The analysis of identifying a “critical window” in which to administer HRT to be either useful or harmful. More and more doctors are now advocating for more significant hormone therapy approaches that factor in individual risks instead of relying on just one-size-fits-all guidelines (Spencer 2024). 

As the debate around hormone therapy continues, these findings emphasize the need for personalized approaches to these treatments, where important factors like age, hormone levels, and even how androgens interact with different patients should be considered in making these decisions. Rather than a one-size-fits-all approach, menopause treatments in the future could include targeted therapies based on the individual's unique hormonal and genetic profile. Highlighting the need for clearer guidelines and better education for both doctors and patients, especially in such delicate treatments like hormone therapy, can make sure that women are empowered to make informed decisions about their health (Spencer 2024) without being held back by a “statistic” or “guideline”. 

References

Meharvan Singh, Neuroscience Seminar Talk, February 18, 2025.

Spencer, B., & Urwin, R. (2024, October 6). The row over HRT and Menopause dividing the Medical World. The Times & The Sunday Times. https://www.thetimes.com/uk/healthcare/article/hrt-treatment-safety-overprescribed-dgcfbg2mg?utm_source=chatgpt.com&region=global