Estrogen, Menopause, and the Brain: Unlocking Cognitive Longevity

Key Takeaways

• The loss of estrogen after menopause has been shown in studies to increase the risk of neurodegenerative diseases.

• Estrogen levels in women start decreasing during midlife with menopause. 

• Estrogen is used for energy production in the brain, when estrogen is high, brain energy is high.

• Hormone replacement therapy and lifestyle changes such as the Mediterranean diet, stress reduction, exercise, and sleep, can reduce risks of dementia.

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The menopausal transition, also known as the stage of life where your menstrual cycle stops, can often make you feel like you’re not yourself.

Women in their 40s and 50s can experience symptoms such as extreme mood swings, weight gain, annoying menopause mind fog, crippling insomnia, hot flushes, or even signs of dementia.

Perimenopause, starting as early as age 35, can also lead to a host of symptoms and increased health risks.

How To Manage Menopausal Symptoms?

Many of these symptoms are temporary and addressed with hormone replacement therapy.

How Does Menopause Affect Our Brain?

If you’re between the average age of 40-50 years old and experiencing night sweats and memory issues, you are not alone.

Menopause is directly linked to several neurodegenerative diseases such as dementia. After this period, a woman’s brain displays significant differences.

Around 60% of women in this age range report difficulty concentrating and other issues with comprehension, commonly referred to as “menopause brain fog.”

This is supported by the long-term SWAN (Study of Women’s Health Across the Nation) trial, which suggests that perimenopausal women may temporarily have trouble learning new information, as well as brain fog with menopause, but it does get better with time.

Can Reduced Estrogen Levels Impact Brain Health?

Estrogen regulates several processes involved in energy production in the brain (5). It helps neurons produce energy more efficiently and plays a crucial role in cognition and memory loss.

High estrogen levels increase the energy available to the brain, while low estrogen levels decrease brain energy. Unfortunately, this can lead to a loss of gray matter in the brain, a significant indicator of Alzheimer’s risk.

The first image has very bright and vibrant colors. In the second image, after menopause, we see lower energy levels This shows there is a 30% drop in brain energy levels after menopause. (6)

While some women experience emotional stability, other women experience heightened mood swings or symptoms of depression. If this sounds like you, consider asking your physician about pharmaceutical interventions like MHT that can alleviate certain emotional symptoms of menopause.

The Impact of Menopause on Estrogen Receptor Density

A Nature publication recently discovered that the number of estrogen receptors in a woman’s brain increases during the menopause transition, independent of age and hormone levels.

Reduced estrogen availability may trigger the brain to upregulate estrogen receptors, increasing estrogen sensitivity. Higher estrogen receptor density in the brain is associated with poorer memory performance and cognitive issues.

How Does Menopause Relate to Dementia?

About 50% of people will develop dementia with age. Dementia impacts many people as they age, but is two times more frequent in women than in men (11).

Since age is a major risk factor, this difference was mainly attributed to women living longer than men. However, another risk factor has been identified by studying dementia associated with Alzheimer’s in post-menopausal women: low estrogen levels.

Throughout their lives, men continue to produce testosterone, which can be converted into estrogen, while women’s estrogen levels get lower and lower with age (12).

Menopause and Alzheimer’s Disease

As this stage begins, decreased estrogen levels can encourage the formation of amyloid plaques between the neurons in the brain. These plaques are a hallmark of Alzheimer’s disease, a form of dementia (6).

While researchers still do not know the exact relationship between menopause and dementia, studies have shown low estrogen levels are a risk factor and that maintaining high estrogen levels can have protective effects (11).

Can Hormone Therapy Reduce the Risk of Dementia?

HRT and Dementia can benefit one another. One way to lower your chances of developing dementia is through hormone replacement therapy. Providing your body with estrogen during this transition may carry a protective effect, reducing the risks associated with low estrogen levels (15).

The North American Menopause Society’s 2022 statement suggests that the use of HRT in women over the age of 65 can be beneficial for several menopausal symptoms, including reducing the risk of dementia.

They recommend individualized, correctly timed treatment, such as hormone therapy, to reduce risks and maximize benefits (14).

How Long Should I Use HRT for Cognitive Longevity?

The duration of hormone replacement therapy (HRT) varies for each individual and should be determined based on personalized factors.

Traditionally, women have been taken off HRT after they are 10 years past menopause onset. However, new research finds that when taken correctly, you may be able to take HRT for the rest of your life. Research finds that this not only promotes cognitive longevity but also reduces all-cause mortality.

It is recommended to consult with a clinician to discuss the best course of action, considering your health history and specific needs.

Non-Hormonal Alternatives

Non-hormonal methods of boosting estrogen levels can be a great option for many people looking to reduce their risk of developing dementia. Various lifestyle changes can be essential in alleviating symptoms.

These Include:

1. Stress reduction techniques such as meditation

2. Cognitive behavioral therapy

3. Diet including seeds, nuts, and olive oil

4. Physical activity

5. Staying social

6. Mediterranean diet (18)

By incorporating these non-hormonal methods and staying informed about women’s health, women can navigate through menopause with improved cognitive function and overall well-being.

It is also important to incorporate foods rich in fatty acids, such as Omega 3 and Omega 6, into the diet to support brain health during menopause.

What Other Factors Besides Menopause Can Cause Dementia?

Besides menopause, several other factors can contribute to the development of dementia.

Exercise Your Brain For Cognitive Longevity

One study found that just three days a week of moderate-intensity exercise, like crossword puzzles, can increase the size of the hippocampus, a part of the brain involved in memory and learning. It is important to address these various factors to promote brain health and overall well-being throughout life.

Menopause Management Matters

Menopause is a critical transition in a woman’s life, impacting everything from brain health to long-term well-being.

With new research emerging on how hormonal shifts affect cognitive function, memory, and the risk of neurodegenerative diseases, staying informed is key to making empowered decisions about your health.

References

1. https://www.parkavendo.com/treatment-specialties/polycystic-ovarian-syndrome-pcos/

2. https://www.ncbi.nlm.nih.gov/books/NBK507826/

3. https://humanbiology.pressbooks.tru.ca/chapter/11-3-endocrine-hormones/

4. https://www.ncbi.nlm.nih.gov/books/NBK535380/

5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4024050/.

6. https://www.youtube.com/watch?v=JJZ8z_nTCZQ

7. https://www.hopkinsmedicine.org/health/wellness-and-prevention/can-menopause-cause-depression

8. https://health.clevelandclinic.org/is-menopause-causing-your-mood-swings-depression-or-anxiety/

9. https://www.forbes.com/sites/debgordon/2021/07/13/73-of-women-dont-treat-their-menopause-symptoms-new-survey-shows/?sh=3c01117454f1

10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2888337/

11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10480684/

12. https://www.alzheimers.org.uk/about-dementia/managing-the-risk-of-dementia/additional-treatments-for-dementia-risk/hormones

13. https://pubmed.ncbi.nlm.nih.gov/38595196/

14. https://pubmed.ncbi.nlm.nih.gov/35797481/

15. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10480684/

16. https://newsroom.uvahealth.com/2021/09/13/cholesterol-drives-alzheimers-plaque-formation-study-finds/

17. https://www.discovermagazine.com/mind/how-do-you-spot-the-signs-and-symptoms-of-frontotemporal-dementia

18. https://neuraleffects.com/blog/dementia-treatment-at-home-natural/