# Gothenburg cohort: women who used menopausal hormone therapy had less brain vessel damage at 70

- Published: 2026-11-08 20:38 UTC
- Section: Life & Health › Neurotechnology
- Tags: menopausal hormone therapy, cerebral small vessel disease, reproductive span, white matter integrity, fractional anisotropy, APOE ε4, Gothenburg H70 Birth Cohort, estrogen and brain health, perivascular spaces, microbleeds
- URL: https://realtech.media/news/rt-7f1eb96848221e18e847a5f1_gothenburg_cohort_women/

**In 352 women aged 70, observational MRI data linked menopausal hormone therapy and longer reproductive span to lower small vessel disease burden.**

![Gothenburg cohort: women who used menopausal hormone therapy had less brain vessel damage at 70](https://realtech.media/media/2026/11/28ad8317f309f98c.jpg)
*Earth.com*

A team led by Giulia Lorenzon (now at Yale School of Medicine) and Anna Marseglia (Karolinska Institutet) reported in Neurology that women who had used menopausal hormone therapy showed less small vessel damage in the brain at age 70. The analysis included 352 cognitively unimpaired women born in 1944 from the Gothenburg H70 Birth Cohort. All had brain MRI, with a 5-year follow-up [1].

Reproductive span was calculated as age at menopause or oophorectomy minus age at menarche. Use of oral contraceptives and hormone therapy was self-reported. According to the publication's summary, about 73% of the women reported contraceptive use and about 61% reported hormone therapy. The outcomes were cerebral small vessel disease burden, Alzheimer's-related cortical thickness and white-matter integrity, measured as fractional anisotropy [1].

## Small vessel disease and white matter

Each additional year of reproductive span was associated with lower small vessel disease burden (OR 0.90, 95% CI 0.83–0.98), mainly through fewer perivascular spaces and microbleeds [1]. Hormone therapy use was associated with lower odds of a higher burden (OR 0.43, 95% CI 0.20–0.92) [1]. According to the authors, the hormone therapy links persisted after adjustment for hypertension, heart disease and diabetes, and after a stricter correction for multiple comparisons. The reproductive span link weakened under that correction.

Oral contraceptive and hormone therapy use were both associated with greater white-matter integrity. Women who used both across life showed the highest fractional anisotropy (OR 0.45, 95% CI 0.12–0.78) [1]. The authors describe this combined pattern as preliminary.

## Alzheimer's-related measures and limitations

Among APOE ε4 carriers, hormone therapy use was associated with greater thickness in cortical areas often affected in Alzheimer's disease (β 0.38, 95% CI 0.01–0.76), but not among non-carriers [1]. This result did not pass the stricter correction, and the authors advise caution. Longer estrogen exposure was linked to stable cortical thickness and white-matter hyperintensity trajectories over time [1].

The study is observational and cannot establish cause and effect. Women recalled hormone use decades later, and the data lack products, doses and start dates. The cohort was healthy, well educated and drawn from one city. Lorenzon stated that the results cannot serve as a basis for recommending hormone therapy for prevention.

## Sources

1. [Neurology](https://doi.org/10.1212/WNL.0000000000218706)
2. [Earth.com](https://www.earth.com/science/women-who-used-menopause-hormone-therapy-had-less-brain-vessel-damage-later-in-life)

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Source: RealTech, realtech.media — https://realtech.media/news/rt-7f1eb96848221e18e847a5f1_gothenburg_cohort_women/