Brain health during menopause
Many women undergoing cognitive problems in menopause often think they are experiencing early-onset dementia. When, in fact, hallmark symptoms of menopause, especially memory loss, brain fog, sleep deprivation, mood swings, and hot flushes are linked to lower levels of oestrogen. It, therefore, appears that ovarian and brain health in women is inextricably linked.
When it comes to dementia women are more at risk than men. Whilst age is the main factor for dementia and let’s face it women tend to live longer than men, this doesn’t completely explain the fact that women make up 65% of current dementia cases.
Why are women more at risk of developing dementia post-menopause?
Most of the research that has been reported focuses on Alzheimer's disease, which is the most common cause of dementia. It’s not fully understood why women are more likely to develop Alzheimer's disease post-menopause than men, but one of the main theories is to do with the hormone oestrogen.
A study published in 2018 suggested that fluctuations in the female hormone oestrogen over a woman's life play a more significant role than the age of the onset of menopause alone.
The study published in the medical journal of the American Academy of Neurology involved 1,315 women from the Medical Research Council National Survey of Health and Development in Great Britain who had been followed since birth in March 1946.
The researchers collected information about age at menopause, either natural, hysterectomy or removal of the ovaries, whether they took hormone replacement therapy and other factors that could affect thinking and memory skills, such as childhood cognitive ability, amount of education, smoking and type of occupation.
The results of the study found that:
846 of the women who entered menopause naturally, those who had a later menopause had higher verbal memory scores
There was very little difference in cognitive ability between those who started menopause early and those who started later.
For the 313 women who experienced menopause due to surgery, there was no relationship between age at the time of surgery and memory scores.
A smaller but more recent study reported by the British Menopause Society in 2021 shares information about the possible link between hormones and Alzheimer’s Dementia. Although small it provides information which strengthens the belief that oestrogen loss in menopause may increase the risk of, measurable risk factors. The findings also suggest that “the window of opportunity for interventions which may prevent Alzheimer’s Dementia in women is early in the menopausal transition.”
They reported that “The role of HRT to reduce risk has not been confirmed but deserves further larger and longer research.”
Your menopause brain health and medical treatment options
Perimenopause may have you thinking that you are losing the plot, rampant anxiety, depression and forgetfulness are part of the brain readjusting to the hormonal changes during your menopause transition.
Your mental health in menopause is paramount to continue functioning normally at work and at home. If you are struggling with any mental health symptoms do talk to your doctor as there are various options to consider from a more holistic approach such as Cognitive Behavioural Therapy (CBT), and of course, HRT!
HRT and Dementia
If you’re on HRT. Until now, research on HRT and dementia risk has been uncertain. But a paper published in the British Medical Journal reported that there’s no overall link between dementia diagnosis and HRT usage. The study tracked over 600,000 women across three decades, ‘This large observational study found no overall association between use of menopausal hormone therapy and risk of developing dementia,’ the authors said. ‘This finding was consistent across different types of hormones, doses, applications, and time of hormone therapy initiation.’
An announcement by the British menopause society in 2022 stated the following. “Women should be reassured that HRT is unlikely to increase the risk of dementia or to have a detrimental effect on cognitive function in women initiating HRT before the age of 65.
However, HRT should not be initiated for the purpose of reducing the risk of dementia in postmenopausal women and at this time, there is not enough evidence to support prescribing HRT for the prevention of dementia.”
Interesting research was published in early 2023 by the University of East Anglia about the potential benefits/links between taking HRT in perimenopause, or early on in menopause and the prevention of dementia. The study reports that “HRT use is associated with better memory, cognition and larger brain volumes in later life among women carrying the APOE4 gene - the strongest risk factor gene for Alzheimer's disease.” It's an observational study and too early to say for sure - more studies to come.
We’re not pushing HRT, we believe women must make their own decision if it is for them depending on the impact their menopause symptoms are having on their overall health and well-being, balanced against their medical history.
What can you do to prevent post-menopause dementia?
One thing is certain, diet and nutrition alongside healthy lifestyle changes can make a marked improvement in your overall post-menopausal health.
And the good news is….
There are proactive steps that you can take to mitigate the early onset of dementia if it is a concern that runs in your family, looking after your health during your perimenopause years will stand you in good stead post-menopause.
