Female hormones might actually make you less crazy!

(HNGN 2014)

New research shows that if women begin taking estrogen supplements before or at the beginning of menopause, their brain structure will be better preserved and protected.

“Everyone should know this stuff” Level

Count to four in your head. Somewhere in the world, dementia has just affected a new patient (NTNU 2016). Though neurodegenerative disease is a concern for all aging humans, the yield of victims seems to favor one gender: 68% of Alzheimer’s victims are women (Gorney 2010). Whether this can be attributed to the fact that women live longer or to other medical causes, protecting our female population from dementia is a pressing issue (Gorney 2010).

New research shows that if women begin taking estrogen supplements before or at the beginning of menopause, their brain structure will be better preserved and protected (NTNU 2016). This preservation may decrease the risk of dementia later in their lives, and researchers are currently working to collect more data and prove the connection (NTNU 2016). So, it looks like estrogen has a hand in preventing dementia. However, before taking that statement as fact, one must understand that timing is absolutely crucial. If women start taking estrogen long after menopause, there is a lower chance that their brain structures will be preserved (NTNU 2016). This specific time that women should start taking estrogen is known in the medical and scientific world as the ‘critical window,’ and will be referred to as such throughout this article (ADDF 2014).

The newest research from the Norwegian University of Science and Technology shows the detection of something specifically unique in the brain structures of postmenopausal women who had taken estrogen during the critical window: a larger hippocampus (NTNU 2016). The hippocampus is the part of the brain that is heavily responsible for sense of place and memory (NTNU 2016). Thus, this is one of the cranial structures heavily affected by types of dementia like Alzheimer’s (NTNU 2016).

How estrogen protects the brain – specifically the hippocampus – on a cellular level, is interesting; the hormone has several functions. Estrogen has the ability to ameliorate energy production, lessen oxidative stress, boost the survival capabilities of damaged brain cells, augment the production of protective chemicals, and expand memory through strengthening neuron to neuron connections (ADDF 2014). Women who start estrogen early on are likely building up their plasticity, which is the ability of the brain to adapt and respond to stimulation (Gorney 2015). Estrogen also strengthens the brain density and builds up the amount of dendritic spines – barbs that protrude from the tails of brain cells in order to connect with neurons for information transmission (Gorney 2015). Therefore, all of these positive functions are protecting the female brain. Kristine Yaffe, chief of geriatric psychiatry at the University of California San Francisco, analyzed many estrogen studies from the last 40 years and came to the conclusion that women who took estrogen during the critical window had at least a 26% decreased risk of later on developing dementia (Yaffe 2010). However, the question of whether estrogen has a solely positive effect on women is still a controversial one.

The benefits of estrogen for older women have been circulating through the science world for decades (Gorney 2010). So, why do only some older women take estrogen supplements? The number of women taking estrogen dropped drastically in the early 2000s (NTNU 2016). This decrease is attributed to the publication of a study that allegedly exposed the extreme health risks of estrogen supplements (NTNU 2016). Research conducted by Women’s Health Initiative seemed to show that taking estrogen and progestin (another female hormone) increases one’s risk for heart disease, breast cancer, and dementia (NTNU 2016).

This research prompted a difficult question concerning whether or not to take estrogen, as many women depend strongly on the hormone for reasons besides preventing dementia – depression, hot flashes, and osteoporosis are a few of many side effects experienced by some menopausal women (Gorney 2010). Again, though, the critical window comes into play: the Women’s Health Initiative patients began estrogen supplements 15-30 years after experiencing menopause, which, as established by newer research, is long past the timeframe for estrogen having a positive effect (NTNU 2016). Most importantly, the WHI study goes on to show that positive results of estrogen do not extend to women who begin taking estrogen multiple years after menopause; taking estrogen later on after bodily levels of the hormone have already dipped does not protect against neurodegenerative diseases (NTNU 2015).

Beyond the critical window, researchers suggest that another criterium is required in order for estrogen to reduce risk of dementia. Not every form of estrogen will be equally productive in preserving the hippocampus (Goldman 2014). There are two main types of hormones typically used in supplements: estradiol, which is the dominant natural hormone in women, and premarin, a more widespread compilation of different female hormones (Goldman 2014). Estradiol has proved more protective for women than premarin (Goldman 2014). From a chemical standpoint, this makes sense, because premarin is made up of more than thirty substances, including progestin (Goldman 2014). Progestin has actually been proven to speed metabolic deterioration in the brains of, at the least, women who were already prone to brain disease because of family history and genetic disposition (Goldman 2014). Therefore, estradiol has proven most effective in preserving female brain health (Goldman 2014).

Preventing and treating dementia will prove to be a more relevant problem as time goes on and the average age of the population increases (NTNU 2016). Because neurodegenerative disease is commonly associated with old age, it will become more prominent, affecting the world from both a social and economic standpoint (NTNU 2016). Thus, taking steps to protect women – the gender more likely to experience dementia – from neurodegenerative disease is commendable research that should prove extremely beneficial in the near and faraway future. Researchers at the Norwegian University of Science and Technology plan to continue to monitor the brain function and health of the women in their study who took estrogen during the critical window, and will likely continue to conduct further studies on estrogen’s effect on the body (NTNU 2016).

“For geniuses only” Level

Estrogen is a hormone – a chemical substance that can transport information and instructions between groups of cells. Hormones can be seen as messengers (Healthy Women 2015). They are able to regulate our growth, development, metabolism, tissue function, reproduction, food consumption, and mood (Healthy Women 2015). The fact that hormones have all of these responsibilities sheds light onto why menopause – which causes a drastic change in hormone levels – has such an effect on the female body.

Estrogen is in some ways an umbrella term for several slightly different hormones, called estrogenic hormones  (Healthy Women 2015). This group is composed of estrone, estradiol, and estriol. Estrone and estradiol are typically produced in the ovaries, while estriol is produced by the placenta, during pregnancy (Healthy Women 2015).

Estrogen primarily performs two of the aforementioned hormone responsibilities: the growth and the development of female characteristics  (Healthy Women 2015). Estrogen is responsible for the growth of the uterine lining during the first stage of the menstrual cycle (Healthy Women 2015). Estrogen controls growth and changes in breast size throughout adolescence and then during pregnancy  (Healthy Women 2015). Bone growth is another area of the body affected by estrogen  (Healthy Women 2015). In that case, the estrogen that female ovaries produce works to prevent bone loss and collaborates with substances like calcium and vitamin D (Healthy Women 2015). This strengthens bone structure and helps to prevent osteoporosis, the medical condition in which one’s bones became brittle and easily breakable (Healthy Women 2015).

A new role of estrogen appears when a woman is pregnant. Estrogen works together with another female hormone, progesterone, to keep ovulation from continuing to occur, as that would be pointless once a woman is already pregnant  (Healthy Women 2015). So, because of estrogen, women do not get their period during those 9 months (Healthy Women 2015).

Impress your friends and family with these three related facts:

Fact 1: Menopause can cause hair thinning, change in skin elasticity/amount of wrinkles, splitting headaches, depression, and sleep disruption (Smith 2016).

Fact 2: Of the top 10 most common causes of death in the USA, dementia is the only one that cannot be prevented, slowed, or cured (Alzheimer’s Association 2015).

Fact 3: Women may lose as much as 20% of their bone mass during menopause (Healthy Women 2015).

Author: This page was created by Alexa Paladino, a senior at Choate Rosemary Hall in Wallingford, CT. Alexa’s spirit animal is the triceratops. Someday, Alexa will be famous for being the first person under 5’3” to reach an object on the top shelf without any help.

Works Cited

(ADDF) Alzheimer’s Drug Discovery Foundation. (2014). Estrogen-containing Hormone Therapy. Alz Discovery. (Date Accessed: 2/2/2016.) http://www.alzdiscovery.org/cognitive-vitality/condition/Estrogen-containing-hormone-therapy.

Alzheimer’s Association. (2015) Latest Facts and Figures Report. Alzheimer’s Association. (Date Accessed: 2/29/2016.) http://www.alz.org/facts/.

Goldman, Bruce. (2014) Estradiol – but not Premarin – prevents neurodegeneration in women at heightened dementia risk. Stanford University. (Date Accessed: 2/5/16.) http://scopeblog.stanford.edu/2014/03/12/estradiol-but-not-premarin-prevents-neurodegeneration-in-women-at-heightened-dementia-risk.

Gorney, Cynthia. (2010) The Estrogen Dilemma. The New York Times. (Date Accessed: 2/5/16.) http://www.nytimes.com/2010/04/18/magazine/18estrogen-t.html?_r=1.

Healthy Women. (2015) Estrogen. Women’s Health. (Date Accessed: 2/27/16.) http://www.healthywomen.org/condition/estrogen.

(HNGN) Ahmed, Rita. (2014) Too Much Of Estrogen Might Double Your Risk Of Dementia. HNGN. (Date Accessed: 2/23/2016.) http://www.hngn.com/articles/23413/20140131/much-estrogen-double-risk-dementia.htm.

(NTNU) The Norwegian University of Science and Technology. (2016) Oestrogen supplements may protect against dementia. AlphaGalileo. (Date Accessed: 1/29/2016.) http://www.alphagalileo.org/ViewItem.aspx?ItemId=160295&CultureCode=en.

Smith, Jody. (2016) 10 Interesting Facts You Might Not Know About Menopause. EmpowHer. (Date Accessed: 1/29/2016.) http://www.empowher.com/menopause/content/10-interesting-facts-you-may-not-know-about-menopause.

Tokar, George. (2011) Estrogen Therapy’s Link With Dementia Risk Depends on Age When Taken, Study Finds. University of California San Francisco. (Date Accessed: 2/29/2016.) https://www.ucsf.edu/news/2011/02/8458/estrogen-therapys-link-dementia-risk-depends-age-when-taken-study-finds.

Yaffe, K., Whitmer, R.A., Quesenberry, C.P., Zhou, J. (2010) Timing of hormone therapy and dementia: The critical window theory revisited. Annals of Neurology. (Date Accessed: 2/29/2016.) 10.1002/ana.22239.