Study links hormonal history to brain vascular health — News-Medical

Researchers have found an association between a longer reproductive period, the use of oral contraceptives or menopausal hormone therapy, and better indicators of small-vessel health in the brain in older age. News-Medical reports on the results of the study, published on November 4, 2026, in the journal Neurology.

The study involved 352 women aged 70 who had no cognitive impairment at the start of observation. Scientists defined the reproductive period as the number of years from the first menstruation to menopause or surgical removal of the ovaries. On average, it lasted 37 years.

MRI examination results Participants underwent magnetic resonance imaging of the brain at ages 70 and 75. The researchers assessed four signs of cerebral small vessel disease: white matter hyperintensities, microbleeds, lacunes, and moderate or severe enlargement of spaces around blood vessels.

Each participant received from zero to four points depending on the number of signs detected. After accounting for education level, number of pregnancies, and total duration of breastfeeding, a longer reproductive period was associated with 8% lower odds of having at least two signs of small-vessel damage.

Cerebral small vessel disease affects small blood vessels and is associated with stroke, cognitive impairment, and dementia. More current news is available on the UA.News Telegram channel Telegram . Use of hormone therapy Among the participants, 73% had ever used birth control pills, while 61% had used or were using menopausal hormone therapy at the time of the study.

After adjusting the data for, among other factors, hypertension and heart disease, women with experience of such therapy had a 59% lower risk of a greater burden of small-vessel damage. They also had less frequent microbleeds and enlarged perivascular spaces. The use of oral contraceptives and menopausal hormone therapy was also associated with better integrity of white matter microstructure, an early indicator of healthier brain tissue.

The most favorable vascular indicators were observed in participants who first used oral contraceptives and later underwent menopausal hormone therapy. The authors emphasized that the work identifies a statistical association but does not prove a cause-and-effect effect of hormones or reproductive-period length on brain health.

Participants reported data on hormone therapy during interviews, so inaccuracies in recall are possible; the researchers also did not track hormone levels throughout life and did not have detailed information on medication use.