Nov 1 2022
Estrogen(s) in the Risk for Alzheimer’s—The Kind You Make, The Kind You Take, and The Kind You Eat.
Welcome! This is your host Ralph Sanchez, and this is episode #21, I am expanding on the last episode, #20, titled: “Estrogen Deficiency and Cardiometabolic Disease Underlies a Woman's Greater Risk for Alzheimer's Disease”. This episode—part two of this two-part episode series—on the linkages between perimenopausal and postmenopausal estrogen declines in women and the risk for age-related disorders— will focus primarily on three types of estrogen:Endogenous estrogen (the kind you make).Estrogen replacement therapies (the kind you take), andPhytoestrogens (the kind you eat and supplement with),and what they potentially represent in a woman’s risk for dementia and late-onset Alzheimer's disease (LOAD). The role of endogenous estrogen is not often inserted into the discussion with regard to a woman’s risk for LOAD and it may be an important risk factor to weigh into a risk evaluation. Note that today’s overview on the estrogen a woman naturally produces throughout her reproductive lifespan—endogenous estrogen—was not part of a previous episode, # 10, that focused on the importance of estrogen replacement therapy in women at midlife. Plus, I’ll revisit estrogen replacement therapy (ERT) and some very important and more recent studies findings on that topic to be aware of, and how plant estrogens, or phytoestrogens, may substitute for ERT. Since this will be a lengthy and dense overview on all of this here today, this summary will be a very abbreviated review of what I covered. First, I’ll reiterate that the discussion and overview on postmenopausal estrogen deficiency as a risk factor for dementia and LOAD should not be a compartmentalized overview on estrogen’s role solely on neurological health. As I detailed in the last episode, the role of estrogen in cardiometabolic health is a significant component that connects a woman’s vascular health, blood flow to the brain and atherosclerosis, in the risk for brain lesions known as white matter hyperintensities (WMHs). And the brain damage associated with said brain lesions (WMHs) are a significant biomarker linked to the risk for cerebrovascular disease and stroke, vascular dementia, and LOAD. Uncontrolled hypertension and atherosclerotic vascular disease restrict blood flow to the brain, and the vital nutrients and oxygen needed to fuel brain function. Please listen in to episode #19 here in which I leverage recent studies on Viagra to make a point about several structure and function aspects of vascular health in aging individuals—both women and men—that are vital and modifiable risk factors for LOAD and vascular dementia. Estrogen Exposure Throughout a Woman’s Lifetime For decades, the research centered around the role of estrogen and estrogen replacement therapy in the risk for late-onset Alzheimer's disease (LOAD) has yielded conflicting results that ranged from:harmful, tono benefit to,protective. In the last episode I explained why there is the seemingly conflicting outcomes that are associated with ERT, so please do listen in to that episode, #20. Regardless, the preponderance of that research on estrogen therapy in the potential risk for LOAD has dealt with exogenous estrogen therapies. However, there is another significant group of studies that must also be noted, and those are the ones that examined the link between the length of a woman’s reproductive years and the endogenous estrogen exposure during those years. Endogenous Estrogen Yes, there is another rich world of estrogen studies that have investigated the lifetime exposure to a woman’s endogenously produced estrogen on cognitive health and the
