How Estrogen Levels In Women Affect Brain Health
Lately, we’ve been talking a lot about hormone health and the benefits of adding hormone replacement therapy in midlife. And there’s a good reason! We keep up with the latest research to help our patients improve their health. Every day we learn more and more about how hormones are intricately connected to all of our organ systems. In midlife women, hormones begin to transition through perimenopause and into menopause. This rollercoaster ride can take 10-15 years, and during that time, women experience many symptoms that negatively impact quality of life. However, it’s only been recently that other, more subtle symptoms have been tied to hormonal changes. These include things like brain fog, worsening or new onset of depression/anxiety, and memory challenges. What we now know is that estrogen levels in women are connected to brain health - and these symptoms may be able to be treated with hormone replacement therapy.
The Brain During Midlife
Have you ever been speaking and just couldn’t find the word you were looking for? Forgot something you usually would never forget? Or has your mood been all over the place - to the point where you are considering medication? There’s a reason why 1 in 5 women aged 40-59 is on anti-depressant medication. What we hear from women coming in for help is that they just don’t feel like themselves, and they can’t pinpoint why. Maybe it’s just the stress of motherhood or their career. But they know something isn’t right. The truth is that these concerns are still widely dismissed by many medical professionals or quickly medicated away without further investigation. But new studies show that they can be (and very likely are) related to the decline of estrogen and the way that it affects the brain. And that’s actually good news - let’s discuss why.
The Impact Of Declining Estrogen Levels In Women
We know that throughout perimenopause, hormone levels fluctuate wildly - sometimes very high, sometimes very low.On average though, there is a steady decline in hormone levels that eventually culminates in menopause (the day you have gone 1 year without a period). After that, you’re considered post-menopausal, which can be confirmed via lab testing. We primarily consider this the end of fertility, but the bigger picture is that it affects your whole body. It is known that estradiol (E2, the most active form of estrogen) signals through binding to receptors throughout the body. In the brain, we have estrogen receptors that control things like blood flow, metabolism, and inflammation.
In a new article, scientists found and studied estrogen receptors in the brain for pre, peri, and post-menopausal women. The results were incredibly insightful - they found that estrogen receptors actually increase over time from pre to post-menopausal which may be a response to the declining levels of blood estradiol. This correlates with many neurological symptoms that women experience, like brain fog, mood changes, and memory challenges. In addition, this could explain why post-menopausal women have higher risk of neurological conditions like Alzheimer's disease (even when compared to men of the same age).
So, What Does This Mean?
The insight provided by this study confirms what we already see in our practice - that these neurological symptoms women experience in midlife are actually connected to real changes in the brain. And, that when we treat patients with proper hormone replacement therapy we can alleviate these symptoms. Even more exciting, we may have a pathway to prevent the onset of degenerative neurological conditions by treating women in perimenopause with HRT. Estrogen may be considered neuro-protective and is an important part of midlife care.
While more research is needed, this is a major breakthrough in our understanding of how important estrogen is in the brain. And more specifically, how some of the common symptoms women experience as they go through perimenopause and menopause may be neurological in origin. If you’d like to learn more about the estrogen-brain connection or discuss this study, don’t hesitate to reach out and schedule an appointment.