by Dr. Jeanette M. Pilotte, MD, FACOG, Women’s Health and Wellness
We think of estradiol as mainly a reproductive hormone, necessary for female reproductive processes and potentially problematic in its loss during perimenopause. However, this hormone has several functions including protective effects for the bones, cardiovascular system and the brain.
I think most everyone is aware of the benefits for the symptoms and for bones and skin, but not everyone is aware of the significant effect estrogen has on the brain.
During the transition to menopause, women may experience sleeplessness, mood changes, depression, weight gain, joint pain, vaginal dryness and pain during sex, among other symptoms.
Bone loss accelerates during perimenopause. And in women who have a genetic risk for Alzheimer’s disease, the first plaques are thought to form in the brain around this time.
Risk of dementia is higher in women: approximately 70% of Alzheimer disease patients are women. The estrogen decline during menopause is emerging as the main basis for the higher prevalence in females.
Estrogen receptors are expressed throughout the brain, with estrogen regulating multiple processes: increased cerebral blood flow, anti-inflammatory effects, promoting neuronal synapse activity — increasing levels of neurotransmitters and receptors, and exerting both neuroprotective and neurotrophic effects on tissues in the brain.
Estrogen has been shown to confer neuroprotective effects against oxidative stress, ischemic damage, and the damage caused by amyloid protein, which is involved in the pathogenesis of Alzheimer’s disease. This hormone also promotes the growth and repair of neurons and stimulates the production of nerve growth factors.
Through these various mechanisms, estrogen has a large influence on emotions, mood and cognitive function, all of which may be affected during menopause, which is when estrogen levels start to decline.
I strongly encourage consideration and education about hormone replacement therapy. Your benefits may include an overall improved sense of well-being, improved cognitive function and a reduced risk of Alzheimer’s disease.