Watching the recent – and second – TV programme about the menopause by Davina McCall, I picked up on new research that appears to suggest a link between menopause – especially reduced oestrogen levels – and the potential for an increased risk of developing Alzheimer’s disease in later life.
I’d heard mention of this theory before but this was the first time I’d been presented with evidence. Davina spoke with US-based neuroscientists Dr Lisa Mosconi and Dr Roberta Brinton, who believe that women should begin taking HRT (Hormone Replacement Therapy) at the age hormone levels start to decrease, because their brains will eventually become more unreceptive to therapy.
While there were many other interesting aspects to the documentary, Sex, Mind and the Menopause, this was the most fascinating and enlightening thing that I learned.
Find out more about the menopause
I have written about other issues of the menopause in my website section Menopause Matters.
Women are more likely to have Alzheimer’s disease
The stark truth, is that two out of every three Alzheimer’s patients are women. Even adjusting for lengthier lifetimes, women outnumber men two-to-one in the Alzheimer’s population.
- In America two thirds of Alzheimer’s patients are women.
- Alzheimer’s Research UK estimates that 61% of people with dementia in the UK are women and 39% are men.
What happens to the brain during menopause?
The Davina programme revealed scans of women’s brains pre-menopause and post-menopause, conducted by Dr Brinton and Dr Mosconi, author of The XX Brain. There was a striking difference.
You can see the PET scans on Dr Mosconi’s website. They reveal a pre-menopausal and post-menopausal brain in a normal woman and not one with dementia. The post-menopausal brain reveals far less activity.
Dr Brinton and Dr Mosconi said the research shows: “Menopause impacts human brain structure, connectivity, energy metabolism and amyloid-beta deposition” and these changes begin in peri-menopause, when most women are in their forties.
Note: Amyloid beta denotes peptides of 36–43 amino acids that are the main component of the amyloid plaques found in the brains of people with Alzheimer’s disease.
HRT benefits and Alzheimer’s research
I decided to investigate Dr Mosconi and Dr Brinton’s work further.
I’d already read that body-identical HRT has been shown to help reduce the long-term risk for women of osteoporosis, heart disease and colon cancer.
Examples of body identical HRT:
- Sandrena gel
- Estradot patches
- Elleste Solo patches.
Now, the research by the US-based neuroscientists reveals that women who took transdermal, body-identical oestrogen and progesterone were 73 per cent less likely to get dementia and other brain-degenerating diseases.
It used to be supposed that the higher rate of Alzhimer’s among women, compared to men, was due to that fact that females live longer on average than males.
However, it seems it could be more related to hormone changes in the menopause years, than ever thought before. This is stunning news, in my opinion.
The new menopause and Alzheimer’s study
The research was led by Dr Brinton, of Arizona University, and studied the health insurance records of almost 400,000 women over the age of 45 for a period of 10 years. Women using the older oral combined HRT showed a 42 per cent reduced risk of neuro-degenerative diseases, such as Alzheimer’s and Parkinson’s.
Meanwhile, women using transdermal eostrogen – for example, oestrogel or patches – had a 73 per cent reduction in dementia, plus a 55 per cent reduction in Multiple Sclerosis, compared to women not using HRT.
Even more interestingly, the study revealed that the longer women stayed on HRT, the better the results.
On the C4 programme, Dr Brinton said: “The critical factor is starting treatment when you have menopausal symptoms.”
When should women start HRT?
- It used to be that women were told they should start HRT a year after the cessation of their periods. The average age would be around 52.
- It used to be that women were told they should stay on HRT for as short a time as possible, and no more than a few years.
Now, the research suggests, women should be replacing hormones as they start to fall and when brain changes start in the peri-menopause phase. For many women this is early to mid-40s.
More than this, taking HRT suddenly, years afterwards when oestrogen receptors have shut down, is often too late.
Brinton told Davina that symptoms such as hot flushes and memory loss are “the canary in the coal mine” and that women who experience serious symptoms should consider HRT or other oestrogen replacement early on.
If you have an early hysterectomy
Analysis of patients in the UK Biobank has newly shown that women who have hysterectomies suffer a slightly increased their risk of dementia – and women who lost their ovaries double their risk of dementia – unless they take HRT.
Conclusion: Menopause, HRT and Alzheimer’s disease
While research is still fairly limited and in its relative infancy – goodness knows, we need a lot more studies and research on the effects of the menopause – it does appear to suggest that that are greater benefits of body identical HRT than previously thought and, in particular, for the potential of reducing the risk of women suffering with Alzheimer’s in later life.
HRT is not suitable for all women but for those that can, there is increasing evidence to show the advantages outweigh the disadvantages.
Of course, as with all medical treatments and therapies, it is important to assess the personal benefits and to be aware of the risks. There is plenty of on-line information and also lots of groups and forums, who can offer excellent advice.
Speak to an understanding and knowledgeable GP, or find a private menopause consultant. It is vital you are properly informed for good health during and after the menopause.