I feel we must be on Exhibit #324 of the Estrogen Hype Machine. This week my social media feed has been filled with menopause influencers making bold claims that a new study is proof that menopause hormone therapy prevents Alzheimer’s disease for women.
The study, Association Between Menopausal Hormone Therapy and Alzheimer Disease Neuropathology, was published August 12, 2026. It’s an interesting study and a good addition to the literature. The investigators identified women who had died and subsequently undergone brain autopsy and were found to have Alzheimer’s pathology, and compared those women with with those who did not have Alzheimer’s.
They researchers used the National Alzheimer’s Coordinating Center (NACC) and the Alzheimer’s Disease Neuroimaging Initiative (ADNI), which are U.S. government-funded research databases that collect and share data on Alzheimer’s disease. These are curated registries, so participants have been evaluated in person, and there is also biological data, like MRIs. This is different from many databases that simply involve looking up diagnosis codes or prescriptions in registries and then trying to gather data from them.
The investigators were looking for any association with estrogen-only MHT and brain biopsy results, any association between MHT and biomarkers, and any link between estrogen-only MHT and a subsequent diagnosis of dementia. “Topical estrogen” was excluded, which I found confusing, because while patches, sprays, and gels are typically referred to as transdermal, they could also be called topical therapy. To be certain, I emailed the authors to clarify, and was told the estrogen in the paper could be oral or transdermal.
The investigators reported that they found “Evidence for small but significant
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