Everyone is scared of dementia.
Women represent two-thirds of Alzheimer’s and dementia cases and those cases are rising fast.
There are a lot of people itching to say AHA IT’S THE ESTROGEN and hormone therapy is the answer.
I think doing so is irresponsible, and here is why.
Yes, right now it’s very tempting to:
- Zero in on a conclusion that the problem must be menopause-driven loss of estrogen, which has protective effects in the brain.
- Draw a straight line between the reduction in brain power we experience during the peri-to-post menopause transition and dementia.
As for #2, while it’s just so perfectly dramatic to say “I thought I had early-onset Alzheimer’s” to describe those scary, brain foggy moments, a) I can’t bear to hear one more celebrity say it and b) comparing the mostly temporary drop in cognition etc in perimenopause with the actual, terrible impact of dementia isn’t ultimately helpful and just leads to more fear mongering, which we are getting entirely enough of these days.
As for #1, I want to make it clear I’m not suggesting no one focus on estrogen: the research in that area is very important and I’m watching it with interest. I’m also calculating that ‘window of opportunity’ – those years right around your last period when menopause hormone therapy is most effective – for myself. Because I really like my brain, and I’m sure you do too.
BUT…
However you believe that we all came to be, you know, human, it just makes no sense that half of us would suddenly develop a brain condition due to the planned, natural end of our fertility, and the other half – who also have a gradual decline of their hormones including estrogen – would not. There is no evolutionary reason for this either (that I can fathom, help me out if you can), especially when you consider the Grandmother Hypothesis. It suggests that we evolved to live a long time after the end of our fertility because we were so helpful in the childrearing of the rest of our tribe. (I’m paraphrasing, and I also like to wildly extrapolate from this hypothesis to include all the helpful things we do in the rest of the world when we don’t have to worry about getting pregnant, or having our period).
AND…
Genetics aside, there are so very many other contributing factors to dementia that we know about, and it’s not a leap to see many of them would hit women harder (and minorities, and people living in poverty, because they have higher rates of dementia too).
My hobby this week was thinking of possible risk factors for dementia and then checking to see if any links had been found. Surely these are things to also consider when it comes to how to take care of your brain?
Here’s a short list:
• Unprocessed trauma or adverse childhood experiences (ACE)
• Sexual abuse or sexual assault
• Anticholinergic medications commonly used medications for allergies, sleep and nausea, like Benadryl, benzodiazepines and Gravol
• Loneliness, with the latest study out of Johns Hopkins published in the Journal of the American Geriatrics Society finding that socially isolated adults had a 27 percent higher risk of developing dementia that people who were not
• Environmental toxins
• Living in fear and anxiety
• Too much mindless scrolling and streaming
And that’s not even considering how the actual fertility arc impacts our risk, or the birth control pill, a relationship that as Scientific American writer Jena Pincott wrote in 2020, we know “shockingly little” about.
It’s hardly a comprehensive list – just some things thrown together off the top of my head. There are also all the well-known risk factors you want to avoid when considering how to take care of your brain – like obesity, smoking, diabetes, high blood pressure, high cholesterol and some autoimmune disorders.
What of all the things we don’t know about yet?
The American neurologist Dr Dale Breseden – and doctors who have trained with him – is treating people based on the premise of his 2017 book The End of Alzheimers. His assertion is that dementia is not only preventable but also in some cases, somewhat or quite dramatically reversible. His work has identified at least 36 contributing factors; menopause hormone therapy in the form of estrogen is just one component of his protocol.
What makes me shudder – and what I know is happening – is someone going on menopause hormone therapy to improve their menopause symptoms or to protect their brain against Alzheimer’s, or both, and then merrily chugging cocktails, regularly popping OTC sleep tabs and living a lie in their soul-sucking marriage. (Just a case study I invented, but really, you can plug-and-play any mix of risk factors).
So yeah, take hormone therapy to help your symptoms.
Take it to protect your brain, even.
But estrogen alone is not going to save your mind.
To give ourselves a fighting chance, we’ve got to do a whole bunch of other stuff too. Lots to do to take care of your brain.
The good news is that it’s all the stuff that makes our life better right now, no matter where you are at in your hormone journey: walking, eating a Mediterranean diet, strength training, getting good sleep, connecting with other humans, managing stress however you can and doing work to keep your brain as strong and flexible as all your other muscles.
Here’s to staying sharp, as long as we possibly can.
Here’s a Magnificent Midlife podcast on how to take care of your brain