Approximately 10 years ago, the Women’s Health Initiative Memory Study (WHIMS) found that postmenopausal hormone therapy in older women caused nearly 2-fold increases in dementia risk, worse rates of cognitive decline over time, and decreased brain volume on magnetic resonance imaging, compared with placebo treatment.1 In the article by Espeland et al,2 WHIMS investigators report new results from the Women’s Health Initiative Memory Study in Younger Women (WHIMSY). The WHIMSY trial cleverly leverages 1272 participants from the Women’s Health Initiative who were aged 50 to 55 years when they were originally assigned to hormone therapy or placebo and reports findings from cognitive assessments administered a mean of 7.2 years after treatment was halted. In these younger women, reassuringly, cognitive function appears similar in those who had been given hormone therapy vs placebo; that is, there is no evidence in WHIMSY of substantially worse cognitive function associated with hormone use at younger ages. These are important data for many menopausal women because estrogen remains the most effective treatment for vasomotor symptoms in menopause and may also be chosen for osteoporosis prevention in those at high risk of fracture.3
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