Dr. Jen Gunter

Yes.

Yeah.

Yeah.

No.

So we had a fantastic review of this at the 2024 menopause society meeting led by Dr. Pauline Mackey is a neuroscientist and, you know, leading researcher in the area where she reviewed all the data that we have on menopause hormone therapy and cognition and what are the gaps.

And we don't have, you know, the problem with many menopause

sort of these big claims, they come from observational databases.

I can pick and choose any observational database I want, I can p-hack, I can do whatever, and we can all come up with something that we want to suit sort of a preconceived outcome.

And so one of the big problems with menopause hormone therapy and databases is the women who tend to take menopause hormone therapy

tend to be healthier, they tend to be wealthier, they tend to live in zip codes with less pollution, they tend to exercise more, things that may not always be caught up in the database, right?

So you don't have equivalent populations.

Maybe getting a prescription for menopause hormone therapy is the catalyst that gets somebody to exercise, right?

So without having randomized double-blinded trials, you can never be definitive, first of all.

I mean, you can't.

Okay, so I would say yes.

There's an exception to every rule.

Sometimes the observational data is absolutely just so overwhelming.

And doing the clinical trial would be unethical.

I think that's also, there are situations like that where it would be unethical to do the clinical trial, so yes.

But so, yeah, there are some observational databases that show that taking menopause hormone therapy is associated with a lower risk of dementia.