The impact of menopause on the brain!

[snowpony]

This episode of diary of a CEO discusses the impact of menopause on our brains:

i am just shocked by this. Do you think this will also cause greater discrimination against women (the fact that proof is now emerging)? I also wonder whether NHS should be offering HRT more widely (and earlier) to potentially reduce the numbers of women with Alzheimer’s.

The problem is that HRT isn’t just one thing. Women like me who have had a hysterectomy just gave oestrogen, others have that plus progesterone, some have testosterone. There are pills, gels, patches, sprays. Huge range of doses. Different ages starting HRT.

personally I feel that if there are long term protective benefits then that’s a bonus, I went on HRT to deal with the awful symptoms I was experiencing at the time.

Yeah, it’s a real thing, HRT was necessary for me due to fatigue and brain fog. Definitely more research needed. My employer runs menopause groups as predominantly female aging workforce. Fatigue, brain fog and lack of sleep are the top three issues raised (amongst 99 others!). Productivity is affected, early retirement, resignation due to sudden struggling in 50s is noticeable.

There seems to be a lack of awareness on this thread that not everyone is able to take HRT.

Women who have had hormone positive breast cancer for example...

@Orangesandlemons77 what were your memory related symptoms if you don't mind me asking? I'm never sure if mine are bad enough to see the GP about

Retirement age used to be 55 because you simply get too fed up and tired to keep working flat out and you likely have to also juggle teenagers or grandchildren and aging parents at end of life at the same time which is extra stress.

I sometimes think that the HRT industry is built around doping up women so we keep pushing ourselves when I think the real issue is humans aren’t made to be at peak performance after 50. We are all made to need to slow down and not have so much work and stress for later middle age.

Retirement ages have been moved up to 68 (and possibly to 70/75) not for any biological reason, but due to economics and shortfalls in state pension funding streams. The HRT industry has been co-opted from addressing a real medical issue into a sort of panacea for the unavoidable biology of aging.

@lateatwork i was a high earner 75-100K per year, workforce cut in half, litigation happy environment, 3 kids 1 year apart (18-19-20) when 45 married to a workaholic. Typical misogynistic workplace. Role cut to part time (not my choice).
I’m not sure my hormone levels had much to do with the chaos that was my life at that stage of the game.
Financial planning early on made retirement at 57 possible.
Im 67 now and relaxing, 42-57 took planning but not because of my hormones, life was complex.

@SummerFeverVenice the study isolates for age (she talks about 3 brains of the same age, 1 pre-menopause, 1 peri, 1 post) that show that menopause is indeed the cause.

How dismissive. Educate yourself.

I was the main breadwinner. Whether I could afford it or not I had no choice but to stop work as I lost the ability to deal with the politics.

I really wish I'd not believed the 'HRT gives you breast cancer' narrative and taken HRT during perimenopause. That was all I needed to do and I didn't do it.

Bollocks.

HRT doesn't 'dope you up'. Quite the opposite.

HRT is a form of hormone doping.

Hormone doping with growth hormone and testosterone for performance enhancement has been rife in sports and only made illegal because it gives an unfair competitive advantage.

It was only a matter of time before legally profitable applications for hormone doping would be found. Middle aged women are especially vulnerable to being told taking hormones as a performance enhancer that will banish fatigue, aches and pains, brain fog, make you feel years younger etc etc.

I agree. I mean we would mostly be dead by 40-50. Look at life expectancy at the start of the 20th century.

Problem is its here to stay. Its also too late now. I wish I'd started a pension at 18.

One of the best natural things going can do is lift heavy weights in the gym. It increases expression of BDNF Growth Factor in the brain responsible for memory and learning.

Menopause hit me like a train and I’m quite happily “doping” with oestrogen as it means I’m not fantasising about killing myself any more.

People banging on about doping and how you just need a bit of positive thinking, yoga and a vegan diet can do one.

Has anybody any experience of starting HRT post-menopause late 50s for continued memory issues - some articles seem to suggest it might help and others say starting too late can add to the dementia risk

This!
It is the politics I am struggling with and now recognise that was a major issue for my mother, and some older friends.

“I really wish I'd not believed the 'HRT gives you breast cancer' narrative”

But even the new forms of HRT do increase risk of breast cancer unless you have had a complete hysterectomy causing surgical menopause and so are on oestrogen only HRT

-HRT that contains oestrogen and progestogen may increase breast cancer risk. This risk may be higher if you take HRT for longer but falls again when you stop taking HRT.
-Oestrogen‑only HRT causes little or no change in the risk of breast cancer.

other risks
-HRT tablets (but not patches or gels) are linked with a higher risk of developing a blood clot.
-HRT tablets (but not patches or gels) slightly raise the risk of stroke. However, it is important to remember that the risk of stroke in women under 60 is very low.

unknown
-It is currently unknown whether HRT affects the risk of developing dementia.

https://www.nice.org.uk/guidance/ng23/ifp/chapter/benefits-and-risks-of-hrt

Thank you @SummerFeverVenice , that’s really interesting.

The research Lisa mosconi is talking about in the podcast is more recent than that article, she also discusses the breast cancer risk (which appear to be unproven due to concerns about the study it was based on).

Did she provide references to this more recent research? And any hint as to why NICE doesn’t know about it?

Which study on breast cancer did she say had concerns about and why does concerns with one study make the increased risk “unproven”? (There have been over a dozen studies on the current types of HRT)

@SummerFeverVenice , when I had my mammogram recently, I was asked if I was on hrt . I asked why was I being asked , and the nurse said it was because of an increased breast cancer risk .

Here we go again

the risks of taking hrt are very low - FAR lower than the risk of drinking alcohol

the benefits are huge.

Dementia and osteoporosis are horrific - if there is something out there that can reduce this misery for countless women we should be doing all we can to develop more products to help.

A mammographer would be more helpful if they asked ‘how much do you drink’ if they are concerned about cancer risk

For alcohol to have an effect on breast cancer risk you have to drink a minimum of 1 alcoholic drink per day, every day (light drinker). At this
level, your increased risk is 1.04 (1.01–1.07) than those who drink less than 1 alcoholic drink per day or drink less than 4 in one sitting or a non drinker.

For example drinking that is 1-3 glasses of wine a week is not any added risk for breast cancer compared to being a non drinker.

HRT risk of breast cancer is a lot lower, with the caveat that the longer you take it the higher your risk. The rough metric is 1.005 if you take it for 5 years but this can be higher or lower depending on your dosage and type of HRT.

The more risk factors you have, the more your risk profile goes up. So it is good to avoid what you can. So if you need HRT, might be wise to cut back drinking alcohol if you are a daily or binge drinker.

HRT does reduce risk of osteoporosis but there are numerous other medications that reduce the risk a lot more without the cancer risk. There are also non pharmaceutical remedies to prevent osteoporosis which have no risks at all- e.g weight bearing exercise.

There is no evidence HRT helps with dementia.

Breast cancer is horrific in its own right, some women may decide that preventing osteoporosis another way is a better choice for them.

I think they should probably ask about ALL risk factors? Excluding any of them is unhelpful.

Actually there is growing evidence that hrt helps reduce dementia. There has been a woeful lack of research into it which isn’t helpful - I think we will have a lot more over the next 5-10 years.

your risk of breast cancer goes up 25% if you have 7-11 units of alcohol a week, Patches increases your risk by 0.5%.

hormone products are used as osteo treatment - prevention is better surely? I agree weight bearing and a good diet should help and we should all be doing that anyway