Menopause, Oestrogen and Alzheimer’s: Investigating the Role of Hormones in Women’s Cognitive Health

With Alzheimer’s disease affecting up to 1 in 10 Australians over the age of 65, understanding how we can reduce our risk of the disease developing is vital for each and every one of us. For menopausal women, declines in oestrogen levels can also increase the risk of Alzheimer’s, with oestrogen playing a crucial role in protecting the brain against the disease’s development. Brain health is a key area of focus for women in every stage of menopause. 

Whether you’re yet to commence perimenopause or you’re in postmenopause, finding more ways to support your brain’s health and longevity is always important. We’re investigating the relationship between menopause, oestrogen and Alzheimer’s, looking to arm you with an understanding of how hormonal fluctuations may impact your cognitive health. 

 

How oestrogen impacts our brain health

Most women are familiar with the importance of oestrogen when it comes to our reproductive health and fertility, but what about its impact on our cognitive health?

Perhaps surprisingly, oestrogen’s role is far-reaching, and it also plays a critical role in our brain health. It’s functions include:

• Increasing blood flow
• Improving brain connectivity
• Preventing the build-up of plaque 
• Supporting energy metabolism 
• Decreasing oxidative stress

When the natural production of oestrogen begins to decrease during menopause, so, too, does its support for these critical brain functions. 

 

Alzheimer’s and menopause

‘There is a growing consensus that menopause may also be an important risk factor for the development of dementia later in life,’ states a 2023 New York Times article. ‘Women going through the life phase, which is clinically defined as the end of fertility, face as many changes in the brain as in the ovaries… while the vast majority of women will weather these changes without long-term health consequences, about 20 per cent will develop dementia in the decades that follow.’ 

With such significant statistics, understanding the link between menopause and Alzheimer’s is crucial – while some of these changes are outside of our control, not all of their impacts are. 

When menopause begins (often between the ages of 45-55), so, too, does the ongoing decline in our natural oestrogen production. Along with the obvious physical symptoms – hot flushes, night sweats, and mood swings – are the changes that can mean our brains are at an increased risk of developing Alzheimer’s.

‘I like to say menopause is a renovation project on the brain,’ says neurologist Lisa Mosconi, whose 2024 book The Menopause Brain looks at the neurological symptoms of menopause and brain-inclusive menopause care pathways. ‘The brain has all these neuronal connections that link to the ovaries, but, with menopause, many aren’t needed and so can be discarded… which can also manifest as vulnerabilities (for some women we also see the onset of red flags for Alzheimer’s disease at this time).’ 

 

 Learn more about how you can manage your health and wellbeing throughout every stage of menopause with the support of our team at the Australian Menopause Centre.

 

Protective measures and precautions

With clear links between menopausal changes and the increased risk of brain diseases, such as Alzheimer’s, taking the protective measures we can is a crucial step in reducing our individual risk factors. 

While there are no guaranteed pathways to preventing Alzheimer’s, particular lifestyle or medical treatments can be beneficial when it comes to reducing the likelihood of its development. These include:

• Hormone replacement therapy. Since hormone replacement therapy mimics the impact of oestrogen on the body, hormone replacement therapy may be able to protect the brain and maintain cognitive function. 
• A regular exercise schedule. Did you know that exercise is one of the most powerful ways to support your brain’s health? A simple walk each day can increase blood flow to the brain, helping to maintain existing pathways and promote the growth of new neurons. Since regular exercise is a powerful lifestyle control throughout menopause, you can enjoy knowing you’re giving your brain a necessary boost every time the sweat begins. 
• Opting for a healthy, balanced diet. The same foods that fuel healthy brain activity before menopause become even more important during and beyond menopause. Since a diet that’s focused on unprocessed, fresh food can help to support cognitive function and reduce the risk of neurodegenerative diseases, focusing on your daily intake is one area where you can give your brain better support throughout the fluctuating hormonal changes of menopause. 
• Keeping your brain busy. Puzzles, developing new skills, reading – anything that keeps your brain active and growing can help to delay the onset of Alzheimer’s symptoms. Thankfully, social engagement is also a key part of keeping that cognitive function protected – so if you were looking for another reason to schedule that brunch catch-up on the weekend, now you’ve got it.
• Keeping stress levels low. Bad news for those with overloaded schedules: chronic stress can have a detrimental effect on the brain, and contribute to faster cognitive decline. Look for any opportunities to reduce your stress levels, and lean into stress reduction techniques like mindfulness or yoga on a regular basis. 
• Maintaining a healthy sleep schedule. While we sleep, our brains get to work. This is their opportunity to clear away toxins, consolidate new memories, and attend to any necessary repairs. Since menopause can already create challenges when it comes to regular sleep routines, prioritising your sleep is one way you can support your cognitive health throughout these crucial years of change. 

The more you can build consistency in these areas, the better you can support your brain (and body) throughout menopause’s constant changes.

 

Conclusion

While menopause is outside of our control, giving our bodies the best quality of support throughout this season is not. By taking careful care to prioritise your cognitive health and offset the impacts of decreased oestrogen production on your brain wherever possible, you can do your best to decrease your risk of dementia or Alzheimer’s developing throughout menopause and beyond.Find more support for your holistic health and wellbeing at the Australian Menopause Centre, with a team of expert doctors and healthcare practitioners on your team. Our personalised treatment pathways provide Australian women with the highest quality of menopause care throughout every challenge it brings.