As dementia and other neurodegenerative diseases develop into more common worldwide, researchers are urgently in search of ways to guard the brain as we age. One area attracting increasing attention is hormones, particularly the role of hormone therapy during and after menopause.
This interest is driven partly by the proven fact that women develop Alzheimer's disease more often than men, especially after midlife, suggesting that hormonal changes around menopause may affect long-term brain health.
Our research has focused on tabulone, an artificial type of hormone therapy prescribed to alleviate menopausal symptoms equivalent to hot flashes and poor sleep. Although it is often prescribed to scale back menopausal symptoms, our results suggest that tabulone may offer significant protection for the brain.
In laboratory studies, Tabulone helped Brain cells survive under stressful conditions. These include consuming less glucose (glucose is the brain's primary fuel) and increase saturated fats equivalent to Palmitic acidwhich is usually higher in obese people. Low glucose intake and high saturated fat are each risk aspects Cognitive decline and neurological disorders.
Tabulone appears to guard brain cells in several ways. It prompts protective proteins, reduces inflammation and limits damage Free radicals. Free radicals are unstable molecules that occur during normal energy production or when the body is exposed to pollution or cigarette smoke. They behave like tiny sparks contained in the cells, until the neutral structure is broken.
Why are women more in danger?
Alzheimer's disease Affects women far more Compared to men, approx Three to one. Even accounting for ladies's longer life expectancy, their risk stays About 12% more.
This gap likely reflects a mix of genetic, hormonal and social aspects. Some genes, including apoE ε4 varianta version of a gene linked to the brain's ability to clear fat and harmful proteins, is related to a better risk of Alzheimer's. Other Jain Can also contribute to chromosomes on the opposite X. Differences in Reproductive historyfor , for , for , . Number of pregnancies and access to Education And health care plays a task, too, as these aspects influence lifelong mental health, cardiovascular risk and the detection and treatment of early cognitive problems.
However, hormonal changes around menopause appear to be particularly essential. When menstruation ends, levels of estradiol (the major type of estrogen) drop rapidly, while follicle-stimulating hormone increases. Both changes are connected to Cognitive decline and Alzheimer's disease.
Many women experience the every day effects of those changes: forgetfulness, difficulty concentrating, slow pondering, low mood, poor sleep and low motivation. Estradiol normally helps brain cells use energy more efficiently. When levels drop, the brain uses glucose less efficiently, developing a metabolic pattern just like that seen in early Alzheimer's.
Estradiol also helps regulate fat distribution and cholesterol. When it decreases, women often gain visceral fat across the abdomen. This variety of fat releases inflammatory chemicals that may damage blood vessels and the brain. Loss of natural anti-inflammatory effects of estradiol Further increases the risk Metabolic syndrome (a cluster of conditions including hypertension and insulin resistance), cognitive decline and dementia.
Can hormone therapy help?
These findings have led researchers to ask whether hormone therapy can offset a few of this risk.
Hormone therapy often combines estrogen and progesterone and is widely prescribed to alleviate hot flashes, insomnia, and mood changes. It can even improve mood and reduce depression, which not directly supports cognitive health.
By the early 2000s, hundreds of thousands of ladies used hormone therapy and reported advantages. Then, in 2002, the Women's Health Initiative (WHI) trial A high risk was reported Breast cancer and cardiovascular events in women taking combined hormones. The headlines warn that hormone therapy “Increases the risk of cancer” leading many ladies to stop treatment or avoid it altogether.
The WHI Memory Studies also found that starting hormone therapy at age 65 or older didn't protect cognition and was related to a better risk of dementia. Later analyzes revealed a crucial factor: timing matters.
Low lifetime exposure to estrogen is connected to Maximizing the rapid cognitive decline and Alzheimer's-related changes within the brain. Women who enter menopause early (before around age 45 to 50) High risks are faced Alzheimer's and more pronounced memory loss. Surgical Menopauseon account of the removal of each ovaries, causes a sudden drop in estrogen and may cause significant problems with memory and a focus, especially in young women.
A growing awareness of the links between menopause and mental health is starting to shape public policy.
In a historic move, Ireland introduced a programme Providing free hormone therapy in June 2025. Eliminating cost barriers allows women to begin treatment earlier and stay on it consistently, conditions that may maximize its advantages.
Elsewhere in Europe, access varies. In England, women who don't qualify at no cost NHS prescriptions can purchase annual hormone therapy Advance Certificate 80 for 19.80. Prescriptions are free in Scotland, Wales and Northern Ireland, while France and Spain partially cover costs through national insurance.
given Safety profile of tabulonereducing financial barriers could improve access and support larger clinical trials to check its effects on mental health.
Hormone therapy isn't a guaranteed strategy to prevent dementia. The strongest protection still comes from a broader approach: effectively managing menopausal symptoms, possibly with hormone therapy, while also controlling blood pressure, cholesterol and diabetes, being physically energetic, sleeping well and avoiding smoking.
Women face a lifetime risk of Alzheimer's on account of interlinked genetic, hormonal and social aspects. Hormone therapy, especially when began around menopause, will help protect cognitive function in addition to relieve symptoms. Along with a healthy lifestyle, it offers a wise tool to support mental health and reduce the gender gap in dementia risk.