A recent study published in eLife suggests that the effects of menopausal hormone therapy (MHT) on brain health are complex and depend on factors such as a woman’s surgical history, duration of treatment, and age at last use. Researchers analyzed data from nearly 20,000 women and found that current MHT users had a higher “brain age gap” (indicating an older brain) than non-users. However, past users showed no significant differences. Women with a history of womb or ovary removal had better brain health outcomes on MHT. These findings highlight the need for a personalized approach to MHT use, as the relationship between MHT and brain health remains nuanced.