Do you know two out of three Alzheimer’s patients are women? Researchers have found this statistic can be explained by a sex hormone that plays a major role in not just the female reproductive system but also the brain — Estrogen.
Estrogen plays a role in regulating women’s fertility, and functions as a neuroprotectant in the brain. A neuroprotectant strengthens neurons and the connections between them. This means estrogen is crucial to neural communication and cognitive function.
What does this all have to do with aging and brain health? As women undergo perimenopause and menopause, estrogen levels drop, causing a decrease in neuroprotection.
A major consequence of decreased neuroprotection in women during this time is the development of cell clusters, called plaques, in their brains, which is directly associated with an increased vulnerability to developing Alzheimer’s. Interestingly, these plummeting levels of estrogen are what cause menopausal symptoms of hot flashes, disturbed sleep, and even depression.
This process begins as early as perimenopause — a transitional stage that starts several years before menopause. Estrogen levels gradually decrease throughout perimenopause and eventually in menopause itself. What comes after menopause, however, is when we get to the silver lining.
It turns out that women’s brains have incredible amounts of plasticity to restore themselves post-menopause. Brain plasticity, also known as neuroplasticity, is the ability of the brain to change its structure and function and form new connections in significant ways. While menopause affects women’s brain connectivity, structure, and energy consumption, these changes, for the large part, are temporary. To compensate for this anatomical change, there is increased blood flow to the brain, and elevated production of molecules called ATP (which are essentially a source of energy). However, recovery rates vary among individuals.
For instance, brain health directly correlates with post-menopausal recovery, meaning women going into menopause with healthy brains should consequently leave menopause with healthy brains. So, what can women do to prepare themselves for this ‘neural doom’? Studies have shown that through lifestyle pillars of nutrition, sleep, and physical exercise, brain health is bolstered and thus more likely to persevere throughout the natural stages in life.
Maki, Pauline M, and Rebecca C Thurston. “Menopause and Brain Health: Hormonal Changes Are Only Part of the Story.” Frontiers in neurology vol. 11 562275. 23 Sep. 2020, doi:10.3389/fneur.2020.562275
Mosconi, Lisa et al. “Increased Alzheimer's risk during the menopause transition: A 3-year longitudinal brain imaging study.” PloS one vol. 13,12 e0207885. 12 Dec. 2018, doi: 10.1371/journal.pone.0207885
Mosconi, Lisa, and Roberta Diaz Brinton. “How would we combat menopause as an Alzheimer's risk factor?.” Expert review of neurotherapeutics vol. 18,9 (2018): 689-691. doi:10.1080/14737175.2018.1510320
Prakapenka, Alesia V, and Heather A Bimonte-Nelson. “Memory and menopause: an unsolved puzzle.” Aging vol. 10,10 (2018): 2541-2543. doi:10.18632/aging.101596
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