Do you sometimes run through all your childrens names first when trying to call the dog? (Amy! Dave! Brian oh, for the love of Beanie!) Recalling whats-her-name who did that thing with that guy in that movie? (You know who, that guy who also did the thing?) If you are a postmenopausal woman, you might be able to blame your fogginess on the length of time your body produced estrogen naturally and how long you took hormone replacement therapy (HRT), also known ashormone therapy (HT).

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Men and women have different sex hormones that have different effects on the brain as we age. A study published online October 16, 2019,in thejournal Menopausehas found that the longer a woman has been exposed to estrogen (from onset of menstruation to menopause or through early use of HT after menopause), the better her brain health and mental flexibility as she enters her sixties.

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The study looked at more than 2,000 postmenopausal women over 12 years to discover what, if any, association there is between estrogen and brain health. They focused on how long the woman had been exposed to estrogen, adjusting for pregnancies (when they would be exposed to more hormones), breastfeeding (when they would have produced less estrogen), and if they took HT for any length of time.(Use of hormonal birth control was not considered because thiscontraception methodregulates, rather than significantly add, estrogen.)

The women were tested at various points on five factors of brain health, including psychomotor skills, memory, identification and association, orientation, and concentration and calculation. It would make sense to define this as broad thinking skills, such as memory, concentration, and being able to make decisions quickly, explainsJoshua M. Matyi,lead study author and doctoral candidate in the department of psychology at Utah State University in Logan.

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This study found that the longer the estrogen window (when women were naturally producing estrogen), the better the womens brain function was. The brain function of participants who took HT remained the same, but was higher than those who did not take HT. Cumulatively, length of estrogen exposure was associated with how the participants would do on the cognitive measure test, says Matyi.

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Many studies on estrogens effect have been conflicting and complex. In 2003, the large Womens Health Initiative Memory Study(WHIMS) showed anincreasein dementia risk for women taking HT. (These are the studies that influenced the application of the black box warning on many HT products.) However," Matyisays, "our results are in contrast to those results. Also, our study shows support for the critical window hypothesis, which suggests that HT should be initiated closer to menopause, rather than later, to reduce any reduce any risks related to thinking and learning abilities.He adds, We also did not see any change in women who started and stopped HT. Thats an indication that the majority of effect occurred years before our study. This means that benefits may potentially continue even after discontinuing.

Some women go into menopause earlier than normal because of cancer treatments or removal of the ovaries.This study shows that for these women (under age 45), early treatment with HT at least until the natural age of menopause (around age 51 in the United States) the benefits will outweigh the risk, unless there is a clear reason to avoid HT, such as breast cancer history.

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The decision gets more complicated as you get older. Weve suggested that any woman going through menopause before the age of 45 should use HT, for the protective effect. unless there is a medical reason not to do so. It helps not just the brain but the heart and bones as well. Its never going to be cut and dried; it has to be weighed out in terms of risk and benefits, saysStephanie S. Faubion MD, medical director ofNAMS, and Penny and Bill George Director of the Mayo Clinic Center for Womens Health in Rochester, MInnesota.

The actions described can provide additional benefit even if you are taking hormone therapy. According to Harvard Health Publishing, you can up your chances of finding your glasses, phone, or keys by following these suggestions:

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Further research is needed on the connection between the brain health and estrogen. These are complicated questions but researchers are looking into it. This study brings us one step close to solving the riddle, says Faubion.

More:
Estrogen May Protect Brain From Cognitive Decline - Everyday Health

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