Early Menopause May Increase a Woman’s Chances of Dementia

TUESDAY, March 1, 2022 (HealthDay News) — Women who enter menopause early are more likely to develop dementia later in life, new research shows.

During menopause, the production of the female sex hormone estrogen decreases drastically and a woman’s periods come to an end. While women usually enter menopause in their early 50s, many do so earlier — either naturally or as a result of a medical condition or treatment such as a hysterectomy (removal of the uterus).

This large study found that women in the UK who entered menopause before age 40 were 35% more likely to develop dementia later in life than women who started menopause around age 50.

In addition, women who entered menopause before age 45 were 1.3 times more likely to develop dementia before age 65, the new study found.

“Women with early menopause may need close monitoring of their cognitive decline in clinical practice,” said study author Dr. Wenting Hao, a Ph.D. candidate at Shandong University in Jinan, China.

The higher risk of dementia may be due to the sharp drop in estrogen that occurs during menopause, Hao said.

“Estrogen can activate cellular antioxidants such as glutathione, reduce ApoE4, the most common genetic risk factor in the pathogenesis of dementia, and decrease the deposition of amyloid plaque in the brain,” she explained.

The buildup of amyloid plaques in the brain is one of the hallmarks of Alzheimer’s disease, the most common form of dementia.

This doesn’t mean that women who start menopause early are powerless against dementia, Hao said.

“Dementia can be prevented and there are a number of ways that women experiencing early menopause can reduce their risk of dementia,” he said. This includes regular exercise, participating in leisure and educational activities, not smoking or using alcohol, and maintaining a healthy weight, she said.

For the study, researchers compared age at menopause and diagnosis of dementia in 153,291 women (mean age: 60) who were part of the UK Biobank, a large database of genetic and health information about people living in the UK. They looked for all forms of dementia, including Alzheimer’s disease.

Postmenopausal women are at greater risk of stroke than premenopausal women, and stroke can cause vascular dementia, but the study found no association between age at menopause and risk of this type of dementia.

While women who entered menopause early had a higher risk of dementia, those who entered menopause at age 52 or later had a similar degree of dementia as women who started menopause at age 50 or 51. , the study showed.

The new findings came after researchers took into account other factors that may increase dementia risk, including age at last exam, race, education, cigarette and alcohol use, body fat, heart disease, diabetes, income and leisure time, and physical activities. The study did not include information about whether women had a family history of dementia or whether women entered menopause early for natural or medical reasons, which could influence the findings.

The findings were presented Tuesday at an American Heart Association meeting in Chicago and online. Research presented at medical meetings is typically considered preliminary until published in a peer-reviewed journal.

These findings are consistent with other studies showing a greater risk of dementia in women with preterm or early menopause, said Dr. Stephanie Faubion, medical director of the North American Menopause Society and director of the Mayo Clinic Center for Women’s Health.

“Early loss of estrogen is linked to an increased risk of multiple long-term adverse health outcomes, and dementia is just one of them,” Faubion said. Others include heart disease, brittle bones, osteoporosis, mood disorders, sexual dysfunction, and early death.

There may be a role for hormone replacement therapy, she said.

“In addition to suggesting monitoring of these women, estrogen replacement is an important strategy and has been shown to reduce the risk of dementia (and other risks) in women with preterm or early menopause,” Faubion said.

For years, hormone replacement therapy was widely prescribed to treat menopausal symptoms and a lower risk of heart disease, osteoporosis and dementia. That all changed when the Women’s Health Initiative landmark study found that taking estrogen and progestin after menopause can increase women’s risk of stroke, heart disease, blood clots and breast cancer. (Estrogen helps with menopausal symptoms like hot flashes and vaginal dryness, and progestin is added to protect against uterine cancer in women who still have a uterus.)

Today, hormone replacement therapy can be prescribed at the lowest dose for the shortest amount of time to maximize benefits and minimize potential risks.

More information

The Alzheimer’s Association gives tips to prevent dementia.

SOURCES: Wenting Hao, MD, PhD candidate, Shandong University, Jinan, China.; Stephanie Faubion, MD, MBA, director, Center for Women’s Health, Mayo Clinic, Rochester, Minnesota, and Jacksonville, Fla., and medical director, North American Menopause Society; March 1, 2022, presentation, American Heart Association meeting, Chicago

This post Early Menopause May Increase a Woman’s Chances of Dementia

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