Dr. Betty MurrayHelping Women Navigate Menopause | Speaker, Author, and Advocate for Women's Health Over 40

How Risky Is Hormone Therapy in Women Over 70?

5 Mar 2026 · 1 min

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1:19

In this monologue, Dr. Betty Murray critiques the current evidence base for hormone therapy in women aged 70 and older. She highlights a substantial "evidence vacuum"—the absence of randomized controlled trials that specifically assess cognitive outcomes after initiating transdermal estrogen in this age group, especially decades after menopause. Murray then examines the Women’s Health Initiative (WHI) Women’s Memory Study, noting that it reported a 49% increase in dementia risk with oral conjugated estrogen but that this finding was statistically non‑significant. She explains that a non‑significant result means the observed difference could be due to chance and argues that presenting such data without emphasizing its lack of significance can mislead the public into perceiving a substantial risk. Murray calls for more rigorous trials and clearer communication of statistical findings to avoid overstating risks.

Chapters

Here's the thing. The evidence vacuum is what's real, right? Because there's a vacuum of evidence doesn't mean the absence of evidence is a substantiation of evidence of risk, right? We have an entire gap. So here's what we do know. There are no randomized trials here specifically examining cognitive outcomes with transdermal estrogen in women 70+ initiating therapy 20 years later. The WHI memory study found non-significant, right? Non-significant. That means it wasn't even— it wasn't enough to be left to chance. So let me clarify that. When a study says we found a difference but it was not significant, right, or non-significant, 49% increased rate of dementia, that means that it, it wasn't even more important than potentially chance. Right? Personally, I feel like they shouldn't even state those kind of data because people read a 49% risk of dementia risk. But if it's non-significant, that meant it was no different than chance, right, with oral conjugated estrogen in women that were 65+. So in that WHI Women's Memory Study, they talk about dementia risk, but it wasn't even valid compared to women who did nothing at all in the study.