David PerlmutterPresident,, Perlmutter Health Center · Board-Certified Neurologist | Functional Medicine Pioneer | #1 New York Times Best-Selling Author | International Speaker | Host of The Empowering Neurologist Podcast

When To Take Hormone Replacement Therapy (HRT)

6 Mar 2026 · 1 min

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In this brief video, board‑certified neurologist Dr. David Perlmutter explains that hormone replacement therapy (HRT) can dramatically lower a woman’s risk of developing Alzheimer’s disease, but only if started during a narrow window after menopause. He cites research indicating the optimal start time is roughly five to ten years after the last menstrual period; initiating HRT later yields much less benefit. Perlmutter recommends a regimen centered on estradiol, balanced with natural progesterone, and suggests that adding natural testosterone may further support brain health.

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Women, when should you start hormone therapy to have the biggest impact in terms of reducing your Alzheimer's risk? Hi, I'm Dr. David Perlmutter. I'm a board-certified neurologist, and I think the data is pretty clear that there is a huge impact in terms of hormone therapy on reducing Alzheimer's risk. That said, the timing is really critical, and I think what the research indicates, 5 to 10 years after the last menstrual period. So starting it later turns out is less beneficial. What should that hormone replacement therapy be? I think it should focus on estradiol and should be balanced out with a natural progesterone and even consider adding in some natural testosterone as well.