Dementia in Women - How Hormones Are Linked to Our Brain Health

Did you know that women are more at risk of developing dementia than men?

A study was done in 2018 on a group of 16,926 women and men of the same age, which revealed that women with dementia outnumber men 2 to 1 and that the rate at which brain cells are dying in the brain is faster in women than in men.
Even though in most case scenarios the main risk for dementia is age, and women tend to live longer than men, this is not a completely valid answer.

Are female hormones linked to a higher risk of developing dementia?
Let’s find out

What is dementia?

Dementia is termed as the loss of basic cognitive functioning such as language, overthinking abilities, remembering, and reasoning.

Dementia is not exactly a disease, it is a collection of symptoms that result from damage or changes to the brain function, either by underlying diseases such as Alzheimer's or not enough clean firepower from your hormones.

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What are the most common types of dementia in women?

There are mainly 5 common types of dementia in women

Alzheimer’s disease

Alzheimer's disease is the most common type of dementia in both men and women. It is caused by changes in the brain, including, abnormal buildups of proteins, known as amyloid plaques and tau tangles.

Deposits of amyloids build up around the brain cells, while deposits of tau tangle inside the brain cells.

Frontotemporal dementia

Frontotemporal dementia is a rare form of dementia mostly noticed in those under 60 years of age. It is caused by the formation of abnormal amounts or forms of the proteins tau and TDP-43

Lewy body dementia

Lewy body dementia is a basic form of dementia that is caused by the abnormal deposits of the protein alpha-synuclein also known as Lewy bodies.

Vascular dementia

Vascular dementia is also a basic form of dementia that is caused by interruptions in the blood and oxygen flow to the brain or damage to the blood vessels.

Mixed dementia

Mixed dementia is a form of dementia that is a combination of two or more of the other types of dementia.

Related article: How Do Hormones Affect Our Mental and Emotional Wellbeing?

What are the signs of dementia in women?

More than 600,000 women in the UK are currently facing dementia. Here are some of the early warning signs of dementia in women

As mentioned above, there are different forms of dementia and each of them can have a different warning sign.

Signs of Alzheimer’s disease

• Reduced memory potential
• Concentration difficulty
• Confusion in doing regular activities, such as the order of things and placements
• Struggling to find the right words in a conversation
• Mood changes

Signs of Frontotemporal dementia

• Behaviour changes as such sleeplessness, overeating and over impulsiveness
• Conversation troubles, such as using the wrong word in a conversation, or speaking in a lower volume
• Easily distracted, refraining you from concentrating on general tasks

Signs of Vascular dementia

• Difficulty trying to fix or stick to a plan
• Slow thought process or understanding late
• Getting lost easily, even in places that you are aware of
• Confused thoughts about time

Related article: 6 Signs of Mental Exhaustion

Can hormones cause dementia?

Although much more research is required to pinpoint why women are more prone to dementia than men, one of the well-known theories is that it has to do with the hormone - estrogen.

A study in 2018 showed that women after menopause had lower levels of required estrogen in their bodies leading to dementia. To back up the statement, their study also showed that women who were going through menopause had better brain development after they were given estrogen therapy to increase the hormone.

Certain other life events that could lower the estrogen levels in the female body can also lead to dementia in women.

A study done in 2022 by the George Institute for Global Health showed that certain reproductive events such as early or late start to menstruate, early menopause and hysterectomy had higher chances of dementia in women.

Whereas being pregnant at some point, having had an abortion and later menopause was linked to a lower risk of dementia in women.

Why is estrogen important to brain health?

Estrogen affects your brain in many ways, including the development and ageing of brain regions that are crucial to higher cognitive functions (like memory).

A 1900 study (on rats) found that estrogen was responsible for increasing the number of connections to a part of the brain called the hippocampus which is important for memory.

Another research work showed that higher estrogen levels may cause the body to make more antioxidants, protecting brain cells from damage.

Related article: Menopause Weight Gain and How to Maintain a Healthy Weight

How is estrogen protecting your brain health?

Forms of dementia, specifically Alzheimer’s are characterised by the proteins amyloid-β (Aβ) and tau. Research shows that the hormone, estrogen could keep the protein at healthy levels.

Although much more research is required to pinpoint how these two proteins can lead to dementia, it is believed that the reason could be the damage or death of brain cells.  

The protein amyloid-β (Aβ) increases the production of molecules called free radicals inside the brain. Free radicals are usually just a byproduct of energy production, but too many of them can be harmful.

Too many of these free radicals in the brain have been linked to Alzheimer's. The good news is that a natural antidote to neutralising these excess free radicals are molecules called antioxidants.

Studies prove that higher levels of estrogen can reduce the number of these free radicals. Studies also show that estrogen could increase the production of antioxidants in the body, thereby neutralising excess free radicals.

Why are women more prone to dementia than men?

Just like estrogen is the female sex hormone, men have testosterone as the male sex hormone.

When women go through menopause (between ages 45 and 55), their estrogen levels start declining. Since estrogen is an integral part of memory, brainpower slowly starts diminishing leading to dementia.

For men, the testosterone hormone is converted into estrogen (known as aromatization) to provide similar functions in the brain.

Since there is no stage at which testosterone declines (unless any medical condition) for men, this particular type of risk leading to dementia in women is not found in men.

Can improving your estrogen levels help you avoid dementia?

The simple answer is Yes!

According to a study led by a physician at the San Francisco VA Medical Center (SFVAMC) and the University of California, San Francisco (UCSF), improving estrogen levels around the time of menopause was associated with a lowered risk of dementia.

It is therefore advised to incorporate lifestyle changes, nutrition, and/or undergo hormone replacement therapy (as shown below) to improve estrogen levels, thereby avoiding the risk of dementia.

Related article: The Menstrual Cycle - Phases, Hormones and Their Functions

How can you improve your estrogen levels after menopause?

There are various medical and natural methods to choose from, to improve your estrogen levels.

Hormone replacement therapy (HRT)

Hormone replacement therapy (HRT) is a treatment used to elevate hormones that depleting as you approach menopause. It helps you relieve most of the symptoms of menopause such as hot flushes, night sweats, lower libido, mood swings, and vaginal dryness.

There are different types of - HRT hormones, ways to take them, and treatment plans. Your health practictioner can help explain which fits best for you to improve your estrogen levels.

DHEA (Dehydroepiandrosterone) supplement

Dehydroepiandrosterone or DHEA is a hormone produced by the adrenal glands. DHEA supplements are mostly made from wild yam or soy. There is still a lot of research required to back it up, but generally, scientists believe that DHEA supplementation can help improve sex hormones such as testosterone and estrogen.

It is wise to keep in mind that DHEA supplementation could increase levels of androgen and have a steroid effect.

In some cases, a change in voice has been noted.

It is therefore advised to consult your GP before including DHEA supplementation, even though it has its benefits in improving estrogen levels.

What can you eat to improve your estrogen levels?

Your gut consists of a combination of viruses, bacteria, and fungi also known as the gut microbiome. Some of them (the good ones) are critical for digestion and immune health. Without a diverse microbiome, your body can’t absorb and use phytoestrogens which help contribute to healthy estrogen production.

Studies show that brain development is abnormal when the gut microbiome is absent.

Scientists at ZOE revealed that following menopause, women are more likely to experience irregular blood sugar levels and post-prandial blood sugar spikes.

Hence it is important to understand exactly what to eat to increase your estrogen levels and improve your gut health.  

Food items that can help improve estrogen production

Soy

Soy is a natural source of isoflavones, one of the most important groups of phytoestrogens or plant-based estrogens.

There are many studies that show that soy isoflavones can decrease the risk of heart disease and breast cancer, as well as reduce symptoms of menopause.

However, it is worth noting that further human studies are required to identify isoflavone's impact on human estrogen production.

Add soy milk to your morning cereal meal, lets go

Flaxseeds

Flaxseeds are a great source of lignans, which is a substance that your body converts into phytoestrogens. Apart from aiding in estrogen metabolism, lignans are also a great source of omega-3 fatty acids and essential fats that your body can’t make on its own.

Studies show that 40 grams of flaxseed consumption a day would help improve estrogen levels which some have argued is equivalent to the levels found in hormone replacement therapy.

Pro tip: Add grounded flax seeds to your dietary intake

Dark chocolate

Dark chocolate is packed with antioxidants and nutrients. It also improves estrogen levels and lowers stress hormones by blood pressure and reduces cravings related to PMS.

Time to go shopping for some dark chocolate

Nuts - almonds, peanuts, pistachios

Nuts like almonds, peanuts, and pistachios are a natural source of phytoestrogen which can help boost estrogen levels.

They are also very easy to add to your diet

Cruciferous Vegetables

Cruciferous vegetables such as broccoli, kale, turnip and cabbage are all rich in indole-3-carbinol, which is produced from a substance called glucobrassicin. Glucobrassicin helps with estrogen production and metabolism and has been shown to help reduce menopausal symptoms brought on by low estrogen levels.

Related article: What Are Macros and Should You Care?

8 Key steps to improve your mental health by Dr Lisa Mosconi

“Although it’s best to optimize your diet for brain health well before you experience any cognitive decline, making these changes whenever you can, will put you at an advantage. Regardless of your age, genetics or medical predispositions, your quality of life can be enhanced by these practices.”

Lisa Mosconi PhD (Director of the Women's Brain Initiative and associate director of the Alzheimer's Prevention Clinic at Weill Cornell Medicine, Author of the books Brain Food and The XX Brain)

• Step 1: Keep your carb intake under control
• Step 2: Get to know the phytoestrogens
• Step 3: Use antioxidants to protect your brain
• Step 4: Choose the right type of fats
• Step 5: Feed your microbes
• Step 6: Control your alcohol and coffee intake and also increase your water intake
• Step 7: Choose to go organic
• Step 8: Eat less (calorie deficit)
  For a more detailed explanation of each step, CLICK HERE

Conclusion

You are more likely to develop a type of dementia after menopause if you are a woman. This is mostly due to the decline in the hormone - estrogen.

But, does this mean that as a woman, you are more likely to face it and there is nothing you can do about it?

Not at all!

It is key to make sure that you have control over your estrogen levels by following a healthy lifestyle, with good nutrition and routine medical checkups.

At Elara Care. we provide you with the tools, guidance and help to keep yourself healthy and on track with your hormones at all times.

Download the free Elara care app today

Resources

Steve Tokar (2011) - Estrogen Therapy's Link With Dementia Risk Depends on Age When Taken, Study Finds

National Library of Medicine (2018) - Differences Between Women and Men in Incidence Rates of Dementia and Alzheimer's Disease

BMJ Journals - W J Cutter, R Norbury, D G M Murphy - Oestrogen, brain function, and neuropsychiatric disorders

National Library of Medicine(2009) - Understanding Estrogen Action during Menopause

ZOE - Can you boost estrogen naturally with what you eat?

National Institute of aging - Alzheimer's Disease & Related Dementias

Lisa Mosconi PhD (2020) - Here’s what women should eat to maintain a healthy brain