GP and women's health professionals study day

GP and women's health professionals study day Medical education

We are seeing an increasing amount of research focussed on oestrogens and cognition. Every study adds to our understandi...
27/08/2026

We are seeing an increasing amount of research focussed on oestrogens and cognition. Every study adds to our understanding of the topic.

Here is a large observational UK Biobank study from Squires et al. exploring the association between Hormone replacement therapy and dementia risk among postmenopausal women.

In this study, in 183,450 postmenopausal women from the UK Biobank (mean 13.3 years follow-up), multivariable Cox regression models evaluated associations between HRT use (≥1 year) and all-cause dementia and dementia subtypes. Stratified analyses assessed modification by menopause type, lifetime estrogen exposure, apolipoprotein E (APOE) ɛ4 genotype, and age at HRT initiation.

Over 2.43 million person-years, 3,948 dementia cases were identified. HRT use was associated with lower all-cause dementia (hazard ratio [HR] 0.90; 95% CI, 0.84-0.96), with stronger associations in surgical menopause (0.74, 0.65-0.84), APOE ɛ4 carriers (0.87, 0.80-0.95) and women with lower endogenous estrogen exposure (0.84, 0.77-0.93). Initiation between ages 46 and 56 conferred the greatest benefit.

The authors concluded that HRT use was associated with lower dementia risk, and these findings may help inform more tailored approaches to HRT prescribing in relation to women's lifetime dementia risk.

Strengths of the study - large amount of available data, follow-up for dementia diagnosis and long follow-up. Women were stratified into various subgroups to show that the association between HRT and dementia risk varies considerably.
Limitations of the study - results are associations and not causal. HRT use is subject to selection (healthy-user) bias, as women who use HRT can differ systematically from non-users including socioeconomic status, educational attainment, ethnicity, and lifestyle factors. Also, lack of information on HRT formulation, dose, and route of administration and potentially participants disproportionally drawn from more socioeconomically advantaged groups.

Observational studies don’t necessarily prove or disprove theories facts, or conclusions. But every little evidence adds to our understanding of long-term effects of HRT and are valuable in counselling patients on benefits and risks.

https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.71679

There is so much talk about menopause, hormone changes, lifestyle, cognitive health and risk of dementia. Every few week...
25/08/2026

There is so much talk about menopause, hormone changes, lifestyle, cognitive health and risk of dementia. Every few weeks, research studies are published which add a little bit to the existing knowledge.
What do we know with certainty at present and what is uncertain? How do we read the conflicting study results and where are the gaps? How do we counsel patients in clinical settings and what management options do we have?
We will try to address there topics in our upcoming RCGP event on 14th October 2026.

Delegates can expect to -
Understand better the cognitive symptoms of menopause transition and how to recognise them
Familiarise themselves with the current knowledge about evolution of and management options for these symptoms
Get to know more about non-hormonal interventions for cognitive symptoms
Discuss the role of hormone replacement therapy in management of cognitive effects of menopause before and after the age of 45

Please join us on the day by clicking the link or search menopause events on the RCGP website to register -
https://engage.rcgp.org.uk/event/a2kWS000000eYPZ/ev07209?recordId=a2kWS000000eYPZ

Thank you Prof Aimee Spector and Dr Alba Soares Pereira for putting this together 🙏🏻.

The latest issue of the New Scientist focusses on ADHD and hormones. It explores the connections between hormone changes...
24/08/2026

The latest issue of the New Scientist focusses on ADHD and hormones.
It explores the connections between hormone changes at times of hormone fluctuations such as perimenopause/menopause and ADHD symptoms/experiences.
Understanding these links can help us provide appropriate care and better support to women who navigate menopause with ADHD.
https://www.newscientist.com/article/2585179-it-is-finally-time-to-talk-about-the-impact-of-fluctuating-hormones/

Here is another useful publication from Moseley et al. addressing ADHD and menopause.
https://www.tandfonline.com/doi/full/10.1080/20533691.2026.2631222

Here is an interesting study by Wang et al. from United States which evaluated temporal trends in oestrogen replacement ...
23/08/2026

Here is an interesting study by Wang et al. from United States which evaluated temporal trends in oestrogen replacement therapy utilisation among younger gynaecological cancer survivors.

This was a cross-sectional study using the Merative MarketScan Research Database from January 1, 2013, through December 31, 2021. Study included female patients aged 18–51 years with a diagnosis or history of gynaecological cancer. Annual prevalence of oestrogen replacement therapy use was calculated, and trends over time were assessed using annual percent change (APC).

What was found?
Oestrogen replacement utilisation increased from 10.9% in 2013 to 14.1% in 2021 among all gynaecological cancer survivors (APC 3.41%, 95% CI 2.13–4.71%). Increasing hormone replacement use was observed across all cancer subgroups and age categories during the study period. Ovarian cancer survivors consistently had the greatest prevalence of hormone use, whereas uterine cancer survivors had the lowest prevalence across the study period. Among the age sub-groups, the 18–34 years old age group had the largest increase in hormone utilisation, from 6.8% to 10.5% (APC 5.68%, 95% CI 3.1–8.33) over the study period.

The researchers concluded that hormone replacement utilisation among younger gynaecological cancer survivors increased between 2013 and 2021. However, overall use of hormone replacement among gynaecological cancer survivors remained relatively low.

As hormone use continues to rise in this population, the authors recommend further research to identify patient-, provider-, and system-level factors associated with prescribing and uptake and to evaluate gaps or barriers in menopausal survivorship care.

It is important to note, though, that these findings should be interpreted with caution as clinical factors, such as menopausal status, ovarian function, symptom burden, and contraindications, were not available in the data source.

Nevertheless, these trends are important to note. It has taken massive efforts from individuals, patients, clinicians and charities/campaigners to point out the gaps in menopause care for cancer survivors and they continue to fight for better treatment and care pathways. There is certainly increasing awareness about long-term effects of surgical or medical menopause and the benefits versus risks of HRT in various types of cancers.

Menopause and Cancer CIC have been at the forefront of fighting for a positive change for cancer survivors menopause care experiences. On 18th September, they are holding the world’s first Global Menopause and Cancer Conference.

It’s an opportunity for healthcare professionals from around the world to come together to discuss the questions that don’t yet have perfect answers, explore emerging evidence and help shape the future of menopause after cancer care. It will not be just about HRT or medical treatments but it will focus how we can improve survivor’s quality of life in a holistic way including lifestyle modifications, ready access to advice, and long lasting support.

Please join us if you can 🙏🏻

Register here: https://menopauseandcancer.org/menopause-and-cancer-conference/

Study link -
https://pmc.ncbi.nlm.nih.gov/articles/PMC13476577/

Here is an observational real-world cohort study from Ting-Fang Lu et al. looking at long-term systemic outcomes of post...
22/08/2026

Here is an observational real-world cohort study from Ting-Fang Lu et al. looking at long-term systemic outcomes of postmenopausal hormone replacement therapy by age at menopause.

Women who initiated postmenopausal HRT containing oestrogen and/or progestogen within 1 year after menopause diagnosis were propensity score-matched 1:1 with non-users using baseline demographic, clinical, and laboratory covariates. Primary matching yielded 83 670 matched pairs in women who experienced menopause at age ≤60 years and 12 175 matched pairs in women who experienced menopause at age >60 years. A minimum follow-up period of one decade was guaranteed.

In the overall matched cohort of women experiencing menopause at age ≤60 years - compared with non-users, postmenopausal HRT was associated with lower hazards of type 2 diabetes and cardiovascular disease CVD. Skeletal health was preserved, evidenced by a lower hazard of compression fractures. HRT was associated with lower hazards of breast cancer, colorectal cancer and venous thrombosis VTE. In the primary age-stratified model, the >60-year cohort showed a higher breast cancer hazard.

These findings have major limitations - residual confounding, incomplete socioeconomic and screening data, limited details on HRT formulation, route, dose and duration, unavailable breast cancer subtype information and unavailable exact maximum follow-up duration.

But, the take home message is that the long-term associations of postmenopausal HRT are not ‘one-size-fits-all’ but depend strongly on age at menopause. In this analysis with all its limitations, postmenopausal HRT was associated with lower chances of heart disease, bone fractures, and blood clots. However, its association with breast cancer varied substantially by age. For women who experienced menopause prematurely (under age 40), postmenopausal HRT was associated with a lower breast cancer hazard. By contrast, among women who reached menopause after age 60, initiating postmenopausal HRT was associated with a higher breast cancer hazard.

Observational studies don’t necessarily prove or disprove theories or conclusions. But every little evidence adds to our understanding of long-term effects of HRT and are valuable in counselling patients about benefits and risks.

Link to the paper and detailed results -
https://academic.oup.com/hropen/article/2026/3/hoag072/8753570

Here is a study on Menopause Hormone Therapy (MHT/HRT), genetic risk for Alzheimer's, and cognition from Emily Budden an...
20/08/2026

Here is a study on Menopause Hormone Therapy (MHT/HRT), genetic risk for Alzheimer's, and cognition from Emily Budden and researchers from Centre for Dementia Studies at the Department of Clinical Neuroscience, Brighton & Sussex Medical School.

Researchers are looking for females in the UK aged 40-60 who are about to start HRT for the first time (but haven’t yet started).
The study involves online questionnaires and memory/thinking activities and a simple inner-cheek swab for genetic analysis.

Taking part will help researchers better understand cognitive health during menopause - an area where much more research is needed.
Study details and the link to take part can be found at:
https://universityofsussex.eu.qualtrics.com/jfe/form/SV_5hy6eIL5HT0thga

Please support (take part or share with others) this important research 🙏🏻

This year’s world menopause day (18th October) theme from the International Menopause Society is ‘Chronic pain at Midlif...
20/08/2026

This year’s world menopause day (18th October) theme from the International Menopause Society is ‘Chronic pain at Midlife’.

Chronic pain affects a significant number of women during and after the menopause transition but remains underestimated and understudied.
There is a need for better research, clinical care pathways, education, recognition and support.

https://www.imsociety.org/education/world-menopause-day-2026/ -medicine

Thank you ASCAT 2026 for the invite to talk on Fertility, Ovarian Reserve Assessment, and Reproductive Options in women ...
19/08/2026

Thank you ASCAT 2026 for the invite to talk on Fertility, Ovarian Reserve Assessment, and Reproductive Options in women with thalassaemia.
There are unique considerations about hormone treatment for hypogonadotropic hypogonadism as well as testing for ovarian reserve and discussing fertility treatment options for women with thalassaemia. Looking forward to the session and learning more and networking on the day.
At UCLH, I am lucky to be working with an excellent haematology team who are proactively involved in multidisciplinary care for thalasaemia patients.

This is the 21st Annual Sickle Cell & Thalassaemia Conference, delivered in continued collaboration with the European Hematology Association (EHA). Academy for Sickle Cell and Thalassaemia (ASCAT) 2026 marks the first chapter of new multi-year conference series, Haemoglobinopathies Without Borders, beginning with Building Care That Lasts: Sustainability in Haemoglobinopathy Care.

https://ascatconferences.com

A wonderful paper from Riley Bove & Ruth Dobson on - ‘Menopause and neurological disorders: a roadmap for research’.Meno...
17/08/2026

A wonderful paper from Riley Bove & Ruth Dobson on - ‘Menopause and neurological disorders: a roadmap for research’.

Menopause and neurology are intertwined in many more ways than we currently understand. In this Roadmap, the authors highlight the historical and scientific challenges that have limited research into the menopause and neurological disease, and set out specific directions for the research needed.

For me, the most interesting section was on brain health after anti-oestrogen treatments such as those for breast cancer.
The authors suggest that studies that have evaluated cognitive outcomes according to type of anti-oestrogen therapy have produced inconsistent results and that there is a clear need for longitudinal analyses of the effects of each anti-oestrogen approach on immediate and long-term cognitive function.

A big thank you to the authors for such a comprehensive document.
https://www.nature.com/articles/s41582-026-01244-5

So, now we will have one more option to prescribe transdermal oestradiol gel to our patients.We had the Sandrena (daily ...
07/08/2026

So, now we will have one more option to prescribe transdermal oestradiol gel to our patients.

We had the Sandrena (daily sachets of 0.5 mg or 1 mg strengths) and the Oestrogel (750 micrograms/actuation) and now it will be the Evorel gel (500 micrograms/actuation) that will be the new additional option.

1 g of Evorel gel contains 1.0325 mg of oestradiol hemihydrate, corresponding to 1.0000 mg of anhydrous oestradiol. Each metered dose delivers 0.5 g of gel, i.e. 0.5 mg of oestradiol (as 0.516 mg of oestradiol hemihydrate). Dose range - 1-6 pumps. The area of application should be at least 2 times the size of the hand. It is not necessary to rub Evorel Gel in, however, it should be allowed to dry for 2 minutes before covering the skin with clothing.

It may take a bit of time before it is available on NHS formularies across the country.

https://www.medicines.org.uk/emc/product/101998/smpc

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