Perimenopause and brain health
- Brain Health Academy
- Jan 6
- 2 min read
Updated: Jan 7
It has been demonstrated that the rate at which the brain ages is influenced by a variety
of psychological, behavioural, and health aspects throughout life in addition to stress.
Suboptimal health habits such as lifetime high-fat diet consumption, excessive alcohol
use, and cigarette smoking has a negative impact on brain health.
Medical conditions that are known to be highly comorbid with affective disorders and
cognitive impairment/dementia, such as metabolic syndrome, cardiovascular
disease, pulmonary disorders, and autoimmune illnesses, must also be evaluated when
thinking about the ageing brain. One well-known risk factor for sub-optimal cognitive function is hypertension.
Lifetime exposure to reproductive hormones and their typical changes affects women's
risk for dementia, emotional disorders, and markers of cellular ageing. Longer telomeres
and lower telomerase levels are linked to higher lifetime exposure to estradiol, which
may indicate that estradiol slows down cellular ageing. Although there is ongoing
discussion over the association between estradiol and dementia risk, several
epidemiologic studies indicate a protective function, and maintaining exposure to
estradiol during the fifth decade of life seems to be essential for brain health in women
who have early menopause.
Estradiol and progesterone production in the ovaries varies greatly and gradually
declines to hypogonadal levels in the postmenopausal phase. Neurotransmitters,
cellular mechanisms, and brain areas linked to the aetiology of mental and cognitive
diseases are all modulated by ovarian hormones. In order to increase the risk or
resilience for neuropsychiatric and cognitive illnesses in old age, external influences that
occur throughout life are likely to combine with characteristics that are fundamental to
women (i.e., typical changes in reproductive hormones).
During the menopause, many women have alterations in their cognitive performance,
most report executive dysfunction, inattention, and poor verbal memory. Subjective
memory impairment is reported by up to 72% of menopausal women; these symptoms
are more common early in the menopause transition and are more likely to be linked to
depressive symptoms.
Women in their perimenopausal and early postmenopausal stages who are starting to
experience cognitive problems might want to think about trying Hormone Therapy (HT),
especially if there are no contraindications and they are having trouble sleeping
because of night sweats. Psychostimulant drugs used to treat attention deficit disorder
have recently demonstrated encouraging results when used to treat executive function
issues that specifically arise during perimenopause. Both subjective and objective
measures of improvement in verbal recollection and executive functioning were reported
in small, placebo-controlled crossover studies with atomoxetine and lisdexamfetamine
(LDX).
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