Estrogen is the master regulator of metabolism in the youthful female brain, orchestrating everything from glucose transport and uptake to its breakdown for energy. [Researcher Lisa] Mosconi’s scans are rainbow-colored evidence that decreased levels of the hormone during menopause, which often starts when women are between the ages of 45 and 55, lead to a “bioenergetic brain crisis,” as she describes it. At some point during this seven-plus-year transition period, up to 60 percent of women experience what is known as menopause-related cognitive impairment: bouts of confusion, distractibility and forgetfulness.
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A 2009 study found that newly postmenopausal women score just as well on cognitive tests as they did before the transition. Decades later, however, roughly a fifth of them will be diagnosed with Alzheimer’s disease. Mosconi and others believe that for many of the 3.6 million women living with the disease in the U.S. alone, menopause might have been a tipping point for cognitive decline.
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The menopause hypothesis—that decline in estrogen levels in this period renders the brain vulnerable to future damage—could offer answers. If Mosconi and other researchers are right, [the] millions of women worldwide who pass through this transition could benefit from lifestyle interventions and, conceivably but controversially, hormone therapy (HT) to prevent the disease.
