Hrt linked to dementia

[Ninaguineapig]

I thought it was supposed to prevent it.

amp.cnn.com/cnn/2023/06/28/health/hrt-dementia-risk-wellness/index.html

Thank you for clarifying, because both men lose testosterone and women lose estrogen from age 30 onwards.

For men, by age 60 testosterone is at 50%.
For women, by age 60 estrogen is at 10%

So, yes women lose more estrogen more rapidly as men lose less testosterone and it’s more gradual.

Although I am not sure that using men as the default control makes sense? As in just because our primary sex hormones decline at different rates to different new baselines, this doesn’t automatically mean men’s bodies are what should happen whereas womens’s bodies are faulty.

@JinglingSpringbells
On dementia, I thought that the gender gap was explained by both the fact that women live longer, so more women live to an old enough age to get dementia. The rest of the gender gap is closed by things that more women suffer such as depression which is risk factor for dementia. I’m the case of Alzheimer’s there is a gene USP11 on the X chromosome that causes Alzheimer’s and so as women are born with two copies of the gene and men only one copy, women are at double the risk from birth.

On dementia, I thought that the gender gap was explained by both the fact that women live longer, so more women live to an old enough age to get dementia.

The fact women live longer than men doesn't equate to more women getting dementia. If you read anything on dementia this is explained in the research.
Alzheimer's is just one form of dementia. There are 4 and vascular dementia is as common as Alzheimer's. Vascular is of course linked to a loss of or poor blood supply to the brain. Many people with Vascular D have evidence (in brain scans) of multiple TIAs/areas similar to a mini stroke that occur during sleep. Before menopause, women are at a lower risk of CVD to men, but post menopause their risk increases an is equal.

I have read some research and that’s why I’m questioning the hypothesised link between estrogen and dementia?

Age is the #1 risk factor for dementia and explains most of the gender gap as to why more women than men get dementia. The WHO lists the risk factors as:
Things that increase the risk of developing dementia include:

• age (more common in those 65 or older)
• high blood pressure (hypertension)
• high blood sugar (diabetes)
• being overweight or obese
• smoking
• drinking too much alcohol
• being physically inactive
• being socially isolated
• depression.

I mentioned depression as well as closing the gender gap because women suffer from depression at higher rates than men, and the men who do suffer from depression tend to complete suicide at a young age. So we have far more women with depression getting to old age, than we do men with depression.

Once you account for these, there is still a gap between men and women in terms of likelihood of developing Alzheimer’s and the USP11 gene is thought to explain most of the rest of the gap.

I am aware that Alzheimer’s is only one sort of dementia, but per the WHO it is the most common form of dementia and accounts for 60-70% of all cases of dementia. So it seems unlikely that vascular dementia could be just as common.
https://www.who.int/news-room/fact-sheets/detail/dementia

Also, on a side note, I thought it was men who are more likely to develop vascular dementia and Lewy body dementia even after menopause?
So seems unlikely that a lack of estrogen would cause either of those!

Age alone is not the agent responsible.
Read this https://www.alzheimersresearchuk.org/blog/why-women-are-bearing-more-of-the-impact-of-dementia/

Why are women more at risk of dementia?

It’s well-known that women tend to live longer than men, but this alone is not enough to explain why women are more likely to develop dementia. Of all people with dementia in the UK, two in three (65%) are women.

We don’t yet know exactly why this is. Some studies have highlighted hormonal changes, differences in the effects of high blood pressure, and different rates of physical activity as potential contributors. But to be able to draw firm conclusions, continued research in this area is crucial. If we can tease apart why certain risk factors may affect women differently, we could uncover important clues that could ultimately help reduce the number of people developing dementia in the future.

Vascular dementia is caused by disturbance to the blood supply. Smoking is one cause. Maybe more older men smoked? (Is this in the stats?) Lewy Body Dementia is linked to Parkinson's disease- similar gene. Men are more at risk of Parkinson's.

Alzheimer's is the most common form of dementia but Vascular is a close second.
Lewy Body Dementia is hard to diagnose and often goes undiagnosed as type of dementia (I've had actual experience of this within my family.)

There is certainly a lot to uncover.

Yes, I agree age alone doesn’t close the gender gap, I have been careful to say as much in all my posts.

From personal experience I would just advise to trust your gut.

I can totally understand all those who are against hrt. I was one of those but unfortunately suffered terribly for 10 years until a young female gynae doctor strongly suggested I just try hrt. It was life changing for me!

I have been taking kliofem tablets now for 10 years but self reduced my dose to half a tablet per day which my GP endorsed.

I have tried to stop taking it gradually on three occasions and each time - the longest period being 6 months - I have gradually felt like an old lady and put on weight despite still taking Thyroxine as I was also diagnosed with an underactive thyroid 12 years ago.

I have now had my preferred GP put a note on my file to say that I do not want anyone else in the practice trying to convince me to stop taking hrt any more unless I suggest it Don't want to switch to gel or patches as the doses are too strong for me and just don't suit me. Strangely enought I could never take the contraceptive pill for long when younger as that didn't suit me either.

I am now 67, very fit and slim. Nothing wrong with my brain at present. I have been learning Japanese for nearly 3 years for at least an hour per day and believe me that certainly keeps your brain alert.🤣

I have regular mammograms and always had my smear checks up until I was 65. I think if anything goes wrong now I can hardly complain.

Just trust your own body I would say. It's about quality of life certainly to me and without hrt my quality is, quite frankly, rubbish.

What happened to my full stop after "Suggest it" and wtf is "Enought"?

Is it happening? 🤣🤣🤣

Sounds like we have the same GP <<eye roll>>

As previous studies, such as the WHI study, I believe this one was poorly conducted and controlled for. I believe that oestrogen supplementation does prevent dementia, prevents bone loss and other illnesses. I have close family members who did not take HRT, were overweight, did not exercise and had poor muscle mass as a result. They now have severe dementia and are 'living' but have no quality of life whatsoever. I am taking HRT and am happy to take the risk that this could prevent the development of dementia.

I have close family members who did not take HRT, were overweight, did not exercise and had poor muscle mass as a result
surely their poor muscle mass was a direct result of being sedentary and overweight?

From personal experience I would just advise to trust your gut.

If I trusted my gut, I’d likely have bowel cancer from eating too much bacon! 😜

Theres a good reason for doing scientific research into the long term safety of everything we put in our bodies.

Menopause changes your metabolism, not for the better, and can therefore cause you to put on weight. But yes not exercising on its own is a risk factor. There are almost certainly multiple causes of Alzheimer's not just one.

The problem with these long lists of risk factors is that it's impossible to separate causation from correlation for most.

Take depression - can be caused by poor diet and lack of Omega-3's. Those will cause depression in a susceptible person and are also independent risk factors for Alzheimer's. So it's highly unlikely that the depression itself is causing the Alzheimer's. Being in the earliest stage of Alzheimer's can also suffer mood disorders. They won't be diagnosed because no one gets diagnosed that early. They can't control for things like that in epidemiology because you can't trust people's self-reported diets and tests to measure nutritional deficiencies, or your levels of Omega 3, are basically never done, let alone in a large study and early subjective mental impairment caused by Alzheimers is not testable in any practical way.

As to genetic causes of the gender gap I don't think that's anywhere close to proven. And ultimately, if this were approached from first principles, and the effects of estrogen (and progesterone and testosterone) on every single system of the body were accepted, the starting assumption would be that losing it will harm all of those systems. The interesting question would be what shapes the undoubted individual variation in women's abilities to biologically adapt to that loss.

if this were approached from first principles, and the effects of estrogen (and progesterone and testosterone) on every single system of the body were accepted, the starting assumption would be that losing it will harm all of those systems.

If we truly applied first principles then we would have ruled out loss of estrogen or low estrogen as a risk factor for dementia. After all men who have much lower estrogen levels than women for their entire lives are less likely to develop dementia. First principles focussed on sex hormones would indicate that a life time with high levels of estrogen is the risk factor for later developing dementia.

First principles suck ass for answering this question because dementia affects the brain, which is not a sex organ. The brain doesn’t rely on high levels of estrogen or testosterone for cognitive function or memory recall.

The only reason estrogen is even being linked is due to our primate brains drawing links between two disparate things that tend to happen almost concurrently. Much like the hypothesised and now debunked link between MMR vaccines and autism. Both happen around the same time- the MMR vaccine and children starting exhibit autistic behaviours. So primate brain linked them- anti vaxxers still link them. But the scientific reality is that there is no link.

its my view pretty much the same thing is going on here with estrogen and dementia. The only proven causal risk factor for dementia is old age.

if this were approached from first principles, and the effects of estrogen (and progesterone and testosterone) on every single system of the body were accepted, the starting assumption would be that losing it will harm all of those systems.

I don't know if you follow Dr Louise Newson but her Twitter feed has a diagrams of exactly that- all the organs in the body that depend on estrogen for optimal functioning.

@ReleasetheCrackHen I left a quote from Alzheimer's and it does say that hormones may be implicated. Dementia is multi-factorial.

The life expectancy of men and women is not that different. In fact the gap is closing. You're looking at a few years.
Dementia can't be explained purely by a woman living 3 years longer than a man.

And, not everyone who lives to their 90s has dementia.

I noticed that a relative of mine started with cognitive issues after 2 surgeries with GA, I wonder about the effects of GA on long term brain health. Also head injuries?

@Pearlsaminga - yes that is exactly what I was saying!

You're not making sense now. Men aren't designed to have high levels of estrogen, or progesterone, they have completely different hormonal systems, and brains. Can you predict what will happen to any given woman's estrogen and progesterone receptors in the brain during and after menopause? Estrogen receptors in the central nervous system and their implication for dopamine-dependent cognition in females - PMC (nih.gov) Estrogen receptors α, β and GPER in the CNS and trigeminal system - molecular and functional aspects | The Journal of Headache and Pain | Full Text (biomedcentral.com) I doubt it.

The brain not being a sex organ is an odd way to put it. And actually any sex therapist will tell you otherwise. All hormones including sex hormones affect the brain, and and all other hormones and neurotransmitters. We're very, very far from understanding those relationships but there's no question they exist. Estrogen and progesterone even affect the gut microbiome for god's sake! Just google it. And although the brain is not a digestive organ, I hope most people are aware by now that the gut and brain are very much connected.

You have no idea what the female brain relies on for cognitive function or memories. I know you don't because no one does and if we did dementia would be cured already. Obviously women with zero estrogen have cognitive function and memories. This is about as far from the point as you can get though.

The onset of Alzheimers and menopause don't happen almost concurrently. And the hypothesis that they're causally related is quite fringe still. So most people's 'primate brains' are making no such connection.

I am planning on dosing myself up to the fucking eyeballs, my mum had a miserable time through the menopause, even if I lost a few years at the end to gain some in the middle it would be worth it, not that I think that is actually the case.

ah, sorry, I must have missed your post!

The problem is there is so much talk of HRT being different these days, bio identical, made from yams etc. That there is an assumption that all HRTbis the newer versions. A lot of people are using Evorel patches - which contain norethisterone.
Utrogestan isn't the wonder hormone for a lot of women, I'm struggling with it badly. I was happy with Evorel patches, but now the guidelines have changed and I had to increase the progestogen side of it. Utrogestan also contains titanium dioxide, I'm having to use it vaginally and I'm not convinced that it is safe.

Yes, it says that hormones may be implicated as in hypothesised and by no means anything close to proven.

Again, in all my posts I have been very careful to say that the gender gap is not wholly explained by more women living longer than men. So I do not know why you are responding to my posts by repeating what I have said from the start.

In addition old age is the #1 risk factor for anyone developing dementia, man or woman, and this is proven.