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hormone replacement therapy maybe it will protect you from a woman’s brain Alzheimer’s disease and dementia — If you take hormones in your 40s and 50s, when menopausal symptoms begin, according to a recent meta-analysis.
The degree of protection appears to vary depending on the type of hormone, the report said.
The average age is menopause The age at the onset of menstruation (defined as when a woman has not had a period for 12 consecutive months) is 51, but women can naturally enter this stage between the ages of 40 and 58. Menopause Society. Symptoms such as hot flashes, night sweats, sleep disturbances, sexual desire disturbances, heart palpitations, and vaginal pain can occur for years as so-called “symptoms.” perimenopause.
“There is a window of opportunity,” said study lead author Dr. Lisa Mosconi, director of the Alzheimer’s Disease Prevention Program and Women’s Brain Initiative at Weill Cornell Medicine in New York City. She says: “Hormones work best on the brain when taken in middle age when menopausal symptoms are present, supporting women through the menopausal state.”
In fact, analyzes show that the brain is more likely to be protected if hormone replacement is started as soon as menopausal symptoms begin. recently published Published in the journal “Frontiers in Aging Neuroscience”.
Duration is also important. As long as a woman started taking hormones during menopause and continued taking them for more than 10 years, her risk of dementia was reduced by 26%.
However, if a woman starts estrogen/progesterone therapy after age 65 or more than 10 years after the onset of menopause, the risk of dementia increases, said Mosconi, a neuroscientist with a qualification in holistic health care. said.
“There is no clear uniformity, but When approached in the right woman, at the right dose, and for the right duration, hormone replacement therapy is one of the most powerful tools for reducing women’s risk of cognitive decline and slowing the progression of Alzheimer’s disease. I believe it can be. ” said Dr. Richard Isaacson, director of research at the Florida Institute for Neurodegenerative Diseases. He was not involved in the study.
“We think this may be especially true for women who carry one or more APOE4 gene mutations, which are present in about 25% of people,” Isaacson said in an email. “It is essential that neurologists and primary care physicians work closely with gynecologists to monitor treatment outcomes over time.”
According to current science, there is more to this story. How harmful or beneficial hormone replacement therapy is, especially for older people, also depends on the type of hormone prescribed.
If the uterus was removed through a hysterectomy, estrogen-only hormone therapy can be prescribed. However, if the uterus is intact, women should take estrogen and progesterone together. Failure to do so may result in the following dangers: Uterine cancer.
For women in their 40s, 50s and early 60s, both types of hormones were protective of brain health, Mosconi said. “When we look at the midlife data, both estrogen-only therapy and estrogen-progesterone therapy have protective effects on the brain, which is good news.”
In fact, those treated with estrogen alone in midlife had a 32% lower risk of dementia, and those who used estrogen and progesterone had a 23% lower risk compared to those who did not use hormone therapy. The analysis revealed that there was a decrease in
Science shows that estrogen protects the brain in several ways. This hormone is a “master regulator” in the brain; important role In glucose uptake. Estrogen regulates the cellular power plants that provide the body’s energy for metabolism.Also supports hormones brain plasticityallowing you to rewire, reorganize, and create new connections.
“Estrogen is involved in billions of different things,” Mosconi says. “It encourages your neurons and brain cells to work stronger, faster, and better. It supports the synthesis of neurotransmitters such as serotonin, which is key to mood, sleep, and appetite. It’s equally important for the immune system, including immunity. It’s an anti-inflammatory hormone that also acts as an antioxidant.”
There’s also good news for older women, Mosconi said, but only if they don’t have a uterus and are on estrogen-only hormone therapy.
“Estrogen-only treatment has no effect if you start taking hormones after age 65 or more than 10 years after your last menstrual period. The overall effect is neutral,” she said. .
However, women who start estrogen/progestogen therapy after age 65 or more than 10 years after their last menstrual period have an increased risk of dementia of up to 30%. Mosconi said it’s still not entirely clear how significant that risk is.
“It was borderline significant,” Mosconi said. “Research is quite mixed. There is a lot of evidence for protective effects and negative effects, but on average, the data seem to point to an increased risk of dementia.”
why? Progesterone may have “antagonistic” effects. Will it change or become dull? Research states that estrogen’s neuroprotective properties are important. Alternatively, new signs of dementia in older people’s brains, such as amyloid plaques and tau tangles, may influence risk. Further research is needed.
“What I found interesting was that in all the studies we looked at, we found a negative association between combining estrogen and progesterone, and the women were taking synthetic progesterone,” Mosconi said. he said.
There are two ways to replenish progesterone. One way is to take micronized, biologically identical progesterone, which has the same molecular structure as that made in the ovaries. Another option is to take a synthetic form of progesterone called progestin. Although it’s similar to the hormone produced in the ovaries, “it’s not the same thing,” Mosconi said.
“Bioidentical progesterone is safer, and there is some evidence that synthetic progestins are responsible for the increased risk,” she said. “But more research is needed on that.”
Many doctors now prescribe bioidentical estrogen and bioidentical progesterone. transdermal patch Dermal administration is a safer route of administration, Mosconi said.
“When you take hormones through your skin, the effect is a little milder because your liver doesn’t have to process them,” Mosconi explained. “When you take something by mouth, those hormones have to be processed by your liver, which can increase your risk of cardiovascular problems.”
Mosconi said good news for older women is on the way. Scientists are developing a new generation of hormone replacement drugs called selective estrogen receptor modulators (SERMs).
“These formulations are specifically designed to target one organ, the brain. They truly deliver estrogen that goes directly to the brain, does not affect reproductive organs, and does not increase the risk of cancer. This is kind of genius because that’s what we want,” she said.
You will no longer need to undergo SERMs It’s a combination of estrogen and progesterone, Mosconi said.
Baki BG/E+/Getty Images
Scientists are working to develop new forms of hormone replacement therapy that act directly on the brain and are safer for menopausal women.
“Estrogen stimulates cell growth, which is associated with an increased risk of uterine cancer,” she says. “But if you have estrogen that doesn’t even go to the uterus, you don’t need progesterone.”
Until science delivers on that promise, experts say women should discuss their hormonal symptoms with a menopause specialist. Every woman is different, and what’s best for one person’s brain health may not be the best solution for another.
Additionally, some women may not be candidates for hormone replacement therapy because of family history, heart disease, or clotting disorders. For such women, Vetted non-hormonal therapy options think about.
