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According to new research by the American Heart Association, women who start the menopause transition before age 45 are more likely to develop dementia later in life than women with menopause at the average age.
Women can use different strategies, one of which is Hormone Replacement Therapy (HRT), to stave off dementia and monitor their cognitive status as they age.
Women Who Experience Early Menopause Have a Higher Risk of Dementia Later in Life
Average, Early, and Premature Menopause Age
Menopause is the time that marks the end of a woman’s menstrual cycle. If you’ve entered menopause, you’ve gone through 12 consecutive months without periods.
This phenomenon happens because the ovaries – the organs that produce the primary female hormone estrogen – have aged significantly during this stage, making much fewer hormones vital for reproductive and sexual health.
Menopause age varies from person to person. On average, American women reach menopause at the age of 51. However, this stage can come a bit earlier or later in some women, ranging from 45 to 55, depending on various factors.
Menopause before age 40 is premature menopause, which affects 1% to 2% of women. On the other hand, early menopause, which affects about 5% to 7% of the population, occurs in women between the ages of 40 and 45.
What Causes Early and Premature Menopause?
Various factors determine the time when a woman experiences menopause. One of these factors is genetics or ethnicity.
Menopause is different for women of color.
Research shows that women of color start menopause earlier than white women. For example, black women experience menopause 8.5 months earlier than white women and worse hot flashes, depression, and sleep disturbances. They are also less likely to access the medical and mental health services that can help them.
Other factors that affect menopause age include lifestyle choices and diet.
Smokers may experience menopause about a year earlier than non-smokers. It is because nicotine lowers estrogen and causes women to enter menopause earlier than they would otherwise. Fortunately, the risk is lower by giving up smoking before menopause.
Meanwhile, women who regularly consume refined pasta and rice began the transition earlier in life than those whose diets are heavier on fish, beans, and other legumes.
Specifically, every daily serving of oily fish, beans, and other legumes is linked to a 3.3-year delay in the onset of menopause. Moreover, consuming more zinc and vitamin B6 can delay menopause by 0.6 and 0.3 years, respectively. In contrast, the average age of menopause is 1.5 years earlier for every extra serving of refined rice and pasta.
Early Menopause and Presenile Dementia
Researchers from the American Heart Association used data from 153,291 women who, on average, were 60 years old when they enrolled in the UK Biobank between 2006 and 2010 to examine the link between age at menopause onset and dementia.
The researchers looked for any diagnosis of dementia, including vascular dementia and Alzheimer’s disease. Then, the rate was calculated after controlling for factors like race, cigarette and alcohol use, BMI, and physical activity.
The study found that:
- A diagnosis of dementia was 35% more likely in women who experienced the menopause transition before age 40 (premature menopause).
- Alzheimer’s disease was 1.3 times more likely to be diagnosed in women who went through menopause before age 45 (early menopause).
- Women who went through menopause later, at 52 or older, experienced dementia at rates similar to those with menopause at an average age of 51.
Researchers did not discover a link between early menopause age and the risk of vascular dementia, though. Instead, they suggested that the women’s decreased estrogen exposure during the reproductive years may be responsible for this added risk. In other words, a lack of hormones is to blame for the increased risk of dementia.
Long-term estrogen deficiency increases oxidative stress, which may speed up brain aging and cause cognitive impairment. Dementia is just one of the numerous adverse long-term health outcomes that increase risk when estrogen is lost early.
Loss of estrogen also raises the risk of heart disease, osteoporosis and fractures, mood disorders, sexual dysfunction, and early death, among other health outcomes.
Prevention for Early Menopause and Dementia
In women who experience premature or early menopause, replacing estrogen is a crucial strategy that has been shown to reduce dementia and other risks.
The most effective way to replace the lost estrogen with the newer one that is bioidentical to human hormones is through Hormone Replacement Therapy (HRT). This treatment aims to normalize the levels of female sex hormones, including estrogen and progesterone, allowing women to gain health outcomes that no other approaches can.
Numerous studies have proven hormone therapy’s efficacy and safety in bringing the optimized hormones back to women. However, data about this treatment for dementia remains limited. In the most recent study published by the BMJ, hormone therapy users of different durations experienced no significant change in dementia risk.
Yet, it’s fair enough to say that the use of Hormone Therapy for delaying and managing dementia in women is on the horizon. Given that premature and early menopause are the primary risk factors for early-onset (presenile) dementia, addressing the estrogen levels is the most straightforward way to keep cognitive impairment at bay.
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