Abstract
Most studies of menopause and brain aging have focused on the role of the sex steroid hormone, estradiol, as a key mechanisms contributing to cognitive and brain aging in women. An emerging literature demonstrates that beyond endogenous estradiol levels, menopausal symptoms, particularly vasomotor symptoms (VMS), are also key determinants of menopause-related changes in cognition and brain function. Critically, that literature shows the importance of using objective techniques to identify associations of VMS with memory performance, brain structure, and brain function. While self-report measures are important patient-centered outcomes in women's health research, objective measures of VMS typically relate more strongly to indices of cognitive and brain health. Currently, it is premature to make a causal claim about VMS and memory dysfunction, but initial findings raise the possibility that women with VMS might experience an improvement in cognition with VMS treatment. More generally, these findings underscore the utility of investigating female-specific risk factors for cognitive decline.
Highlights
The burgeoning field of research in menopause and brain health has its roots in the discovery, more than 30 years ago, by Catherine Woolley in the laboratory of Bruce McEwen that the structure and function of the hippocampus is influenced by changes in physiological levels of the sex steroid hormone, estradiol [1, 2]
While there is a clear role for research on the role of sex steroid hormones in brain aging, comparatively little work has been conducted on the role of menopausal symptoms in brain aging
We present an overview of vasomotor symptoms (VMS) in relation to cognition and brain function at midlife and beyond
Summary
The burgeoning field of research in menopause and brain health has its roots in the discovery, more than 30 years ago, by Catherine Woolley in the laboratory of Bruce McEwen that the structure and function of the hippocampus is influenced by changes in physiological levels of the sex steroid hormone, estradiol [1, 2]. This foundational discovery propelled the growth of basic science research on the role of sex steroid hormones in brain function and brain structure, establishing a protective role in both rodent and non-human models. If VMS contribute to cognitive dysfunction in women, any effective treatment for VMS regardless of whether the treatment is hormonal, non-hormonal, or lifestyle, could potentially confer cognitive benefit
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