Most of us entering menopause will question it. Ugh! Is this in my head?! To some extent… it is! But not quite how you think. When we have hot flashes, memory lapses, night sweats, insomnia, depression, and anxiety, these symptoms start in the brain.

It’s important to remember you’re not crazy!! You’re not alone, either! If you’ve got a vagina… you’ll get menopause! A natural fact of this world. White knuckling our symptoms won’t make them go away.

So, what is there to *keep in mind* to *keep our minds*? Knowing menopause’s effect on the brain is key to getting ahead. Studies have shown late intervention in menopause–especially combined with early onset menopause– can increase our risk for Alzheimer’s Disease.

The Impact of Estrogen on the Brain

According to the Alzheimer’s Association, women comprise two-thirds of the population suffering from Alzheimer’s Disease. It is important to note that women live longer, and age is the single biggest risk factor for Alzheimer’s disease. Researchers think hormonal changes play a big role in this gender disparity.  The big question is, what does the main female hormone, estrogen, have to do with brain function??? It turns out a lot!

Lisa Mosconi, Ph.D., Director of the Alzheimer’s Prevention Program and the Women’s Brain Initiative at Weill Cornell Medicine and New York-Presbyterian explains the impact of estrogen and the brain, “Estrogen literally pushes neurons to burn glucose to make energy. If your estrogen is high, your brain energy is high. When estrogen declines, your neurons start slowing down and age faster.”  She further explained that studies show that this process can lead to the formation of amyloid plaques.  These plaques are the hallmark of Alzheimer’s disease.

Hormonal Aging and Alzheimer’s Disease

According to a study published in JAMA NeurologyTrusted Source, early age at menopause may be a risk factor for Alzheimer’s disease dementia.

The link between hormonal aging in women and Alzheimer’s is so noticeable it’s now taken center stage. “A surprise revealed by tau PET imaging was that women tend to accumulate more tau tangles than men at the same clinical stage of Alzheimer’s disease.”

If someone walked up to you on the street and said menopause affects your tau, you might roll your eyes. But we’re not talking about Taoism and finding your Chi. This tau is a protein in your brain. It’s a small word with a big reputation because of its association in tangles with Alzheimer’s Disease.

You’ll need more than an Olaplex smoothing cream to sort out these tangles, though! This Spring, a report came out showing “women with early Alzheimer’s Disease (AD) whose menopause began before the age of 46 – or who had started hormone replacement therapy late – tended to have more tangles than their comparison groups.  The data echos previous findings of greater dementia risk in women who started taking hormones many years after menopause.”

Dr. Roberta Diaz Brinton at the University of Arizona commented on the report by agreeing that HRT initiated at the time of and prescribed for menopausal symptoms reduces the risk of developing Alzheimer’s disease.

Dr. Brinton says: “The critical factor is starting treatment when you have menopausal symptoms.”  She further explained that the goal is to replace hormones as they start to fall, as brain changes begin in perimenopause. Giving HRT suddenly, years afterward when estrogen receptors have shut down, is often too late. Brinton says symptoms like hot flushes and memory loss are “the canary in the coal mine”, and women who experience serious symptoms should consider HRT or other estrogen replacement early on.

In another study published in Alzheimer’s & Dementia: Translational Research & Clinical Interventions, Dr. Roberta Diaz Brinton studied the health insurance records of almost 400,000 women over 45 for ten years. Even women using the older oral combined HRT showed a 42 per reduced risk of neuro-degenerative diseases like Alzheimer’s and Parkinson’s Disease, but women on transdermal estrogen had a 73 percent reduction in dementia and a 55 percent reduction in Multiple Sclerosis compared to women not using HRT. The longer women stayed on HRT, the better the results.

As an aside, you might want to read about the new Alzheimer’s drug recently approved by federal regulators.

Hormone Therapy and Brain Health 

Medical jargon and data can feel confusing and overwhelming, especially when battling brain fog and fatigue.

You might be seeing all kinds of scary headlines about the Denmark Study, which suggests that hormone therapy was associated with an increased risk of developing Alzheimer’s disease and other types of dementia.

Before you start ripping off your estradiol patch, please continue reading!

The study contradicts earlier studies suggesting that HRT may protect against cognitive decline if the treatments start near menopause onset. Researchers from the Mayo Clinic and Harvard Medical School issued an editorial titled “A Causal Link Remains Unlikely,” noting that the study didn’t provide evidence that hormone therapy causes Alzheimer’s or other dementias.

The Menopause Society, formerly known as the North American Menopause Society, sent out a notice to its members, who are made up of certified practitioners, that the biggest limitation of the study is that it was observational. Dr. Stephanie Faubion, medical director of the Menopause Society and director of the Mayo Clinic Center for Women’s Health, said that doctors should not change their practice based on this study because they are unable to establish causation.

“If you have symptoms of menopause — hot flashes, insomnia, depression, brain fog — you’re more likely to ask for hormones,” said Dr. Lisa Mosconi, director of the Alzheimer’s Prevention Program at Weill Cornell Medicine. A study published last year showed that higher rates of hot flashes were linked to an increase in the amount of white matter hyperintensities. The lesions are “considered a risk factor for dementia,” Dr. Mosconi said. (It’s unclear whether hot flashes cause damage to the brain or if the hot flashes and the white matter damage share an underlying cause.)

Studies have shown that those symptoms do have a link with the development of Alzheimer’s and other dementias. Basically, HRT is shown to improve serious risks related to menopause and is considered a key component in also preventing cognitive impairment (like Alzheimer’s/dementia). Early age of menopause is a red flag for AD dementia. (Early menopause is defined as menopause beginning before age 40, sometimes induced by medical intervention like a hysterectomy.)

Timing around HRT is everything. Women who began menopause early and were prescribed HRT around the age of onset menopause did not show an increased risk for Alzheimer’s. If you or someone you love goes into early menopause, do not wait – get them to a menopause specialist! ASAP!!!

Even if you don’t experience early menopause, if you are experiencing menopause symptoms, be sure to reach out to your menopause specialist and discuss whether HRT is right for you.   Remember: lots of TAU means less TAO… more risk = less zen!

It’s a no-brainer!

My Motto:  Suffering in silence is OUT! Reaching out is IN!

If you want to educate your employees, colleagues, or friends about menopause, look no further! Book Ellen for your next event.

Sign up for MENOPAUSE MONDAYS® Blogs

Be sure to follow me on Instagram @menopause_mondays.

Follow me on TikTok  @menopausemondays

Sign up for my fun YouTube Videos!

Download my free eBook: MENOPAUSE MONDAYS the Girlfriend’s Guide to Surviving and Thriving During Perimenopause and Menopause.

* does not recommend, endorse, or make any representation about any tests, studies, practices, procedures, treatments, services, opinions, healthcare providers, physicians, or medical institutions that may be mentioned or referenced.

This post originally appeared on

The Impact of Estrogen On The Brain was last modified: by

Sharing is caring!