Get inspired by this weekly roundup on living well, made simple! Sign up for CNN’s Life, But Better newsletter to receive valuable information and tools designed to help improve your overall well-being.
According to a recent meta-analysis, hormone replacement therapy (HRT) taken in the 40s and 50s may protect the female brain from Alzheimer’s disease and dementia. The degree of protection varies depending on the type of hormones used. The average age of menopause onset is 51, but it can occur naturally anywhere between the ages of 40 and 58. Symptoms such as hot flashes, night sweats, sleep disturbances, and libido and vaginal pain can occur for years leading up to menopause, known as perimenopause.
Dr. Lisa Mosconi, the lead author of the study, emphasizes the importance of taking hormones during midlife when menopausal symptoms are present to best support women through this transition. The analysis, published in the journal Frontiers in Aging Neuroscience, also found that the brain has a higher chance of being protected if hormone replacement is started soon after menopausal symptoms begin. Taking hormones for more than 10 years while in menopause reduces the risk of dementia by 26%. However, starting estrogen-progesterone therapy after the age of 65 or more than 10 years after the start of menopause can increase the risk of dementia.
Dr. Richard Isaacson, director of research at the Institute for Neurodegenerative Diseases in Florida, believes that HRT can be a powerful tool in reducing a woman’s risk for cognitive decline and Alzheimer’s pathology, especially for women with the APOE4 genetic variant.
It’s important for neurologists, primary care physicians, and gynecologists to collaborate closely and monitor treatment outcomes over time. The type of hormones prescribed also plays a role in whether HRT is harmful or helpful. Estrogen-only hormone therapy can be prescribed if a woman has had a hysterectomy. If the uterus is intact, a combination of estrogen and progesterone should be used to avoid the risk of uterine cancer.
Both types of hormones, estrogen-only and estrogen-progesterone therapy, are brain-protective in midlife. Estrogen protects the brain in various ways, including its role as a “master regulator” in the brain, its involvement in cellular energy production, and its support of brain plasticity. Estrogen is also vital for the immune system and acts as an anti-inflammatory and antioxidant hormone.
For women without a uterus, estrogen-only hormonal therapy can be beneficial even in older age. However, starting estrogen-progestogen therapy after age 65 or more than 10 years after menopause has neutral effects. There is also a 30% increased risk of dementia associated with starting estrogen-progestogen therapy after age 65 or more than 10 years after menopause. The reasons behind this increased risk are not entirely clear and further research is needed.
Dr. Mosconi finds it interesting that studies showing a negative association with estrogen-progestogen therapy used a synthetic form of progesterone. Further studies on the safety of bioidentical progesterone versus synthetic progestins are necessary.
Experts recommend discussing hormonal symptoms with a menopause specialist to find the best solution for each individual. Nonhormonal options are available for women who are not suitable candidates for hormone replacement therapy due to factors such as family history, heart conditions, or clotting disorders.
Stay informed and make the best choices for your well-being! Sign up for CNN’s Life, But Better newsletter to receive more valuable information and tools.
