Menopause
Post-menopause memory decline linked to loss of oestrogen production in brain tissue – study

Oestrogen loss in brain tissue may help explain memory decline after menopause and women’s higher Alzheimer’s risk, a preclinical study suggests.
The findings suggest females may be especially sensitive to the loss of brain oestrogen in old age.
Scientists said the work could point to future treatments focused on restoring the brain’s supportive environment before memory loss develops.
Dr Hong Zhao, research professor of obstetrics and gynaecology in the division of reproductive science in medicine at Northwestern University Feinberg School of Medicine, said: “This study tells us that females, but not males, may be uniquely sensitive to loss of brain oestrogen at old age, potentially contributing to an increased risk of Alzheimer’s disease.”
Researchers at Northwestern University studied young and old male and female mice, with and without loss of brain oestrogen.
The study focused on the extracellular matrix, or ECM, a network of molecules in the space between brain cells. It helps support communication between cells and is important for memory, brain development and brain health. The ECM makes up nearly 20 per cent of the brain’s volume.
The ECM is especially abundant in the hippocampus, a part of the brain involved in learning and memory.
Scientists found that oestrogen loss, ageing and female sex were closely linked to changes in the ECM. The study is the first to examine oestrogen loss in the ECM.
The findings may help explain why women are at higher risk of Alzheimer’s disease, although the research was carried out in mice and further work is needed to understand whether the same mechanisms apply in humans.
Nearly two-thirds of people with Alzheimer’s disease in the US are women, but the reasons for this higher risk remain unclear.
Scientists have long suggested that falling oestrogen levels after menopause may reduce the brain’s natural protection against memory loss and neurodegeneration. Neurodegeneration means the gradual damage or loss of nerve cells in the brain.
Dr Serdar Bulun, chair of the department of obstetrics and gynaecology at Feinberg and a Northwestern Medicine physician, said: “We have provided some of the most compelling evidence that oestrogen is so important for memory function and other mood functions in the female brain.
“This should motivate clinicians to be more aware of the essential role of oestrogen for women’s brains, because once memory is gone, it’s gone.”
Before menopause, the ovaries are the main source of oestrogen in women. After menopause, oestrogen levels drop sharply, and only small amounts are produced in other parts of the body, including the brain, fat tissue, bone, muscle, blood vessels and breast tissue.
In mice, oestrogen is produced locally in the brain and gonadal fat in males, whereas in females it is produced mainly in the brain.
Research has shown that women with Alzheimer’s disease may have even lower oestrogen levels in the brain than women without the disease. The study further supports that.
The researchers used genetically engineered mouse models that lacked aromatase, an enzyme needed to produce oestrogen, either throughout the whole body or only in the brain.
They examined how the loss of oestrogen affected memory, behaviour and social function in male and female mice at young and old ages.
They also analysed changes in gene expression across the entire genome in the hippocampus in mice with brain-specific oestrogen loss at young and old ages in both sexes.
The authors said the findings suggest the ECM could become a target for future treatments.
Current Alzheimer’s treatments such as lecanemab and donanemab are designed to remove amyloid, an abnormal protein build-up in the brain that is one of the main signs of the disease.
However, researchers said it is still unclear how much these treatments help to slow memory loss or improve everyday functioning. Some studies suggest small benefits, while others show little meaningful improvement.
The study suggests a different approach could focus on restoring the brain’s supportive environment to help protect memory.
Zhao said: “Our findings will hopefully motivate future studies to better understand how this matrix is altered in postmenopausal women, and how it could potentially induce susceptibility to Alzheimer’s disease.”
Hormone replacement therapy, or HRT, has also been studied as a possible way to protect women from Alzheimer’s disease by restoring oestrogen levels.
However, clinical studies have produced mixed results, with some suggesting benefits for memory and cognitive function while others show little benefit or possible harm.
Zhao said differences may depend on the type of hormone treatment used, the age at which it begins and differences in study design.
She said: “More research is needed to understand how oestrogen affects the female brain and why oestrogen loss increases AD risk in women.
“Understanding these mechanisms could help researchers develop safer and more effective HRT strategies to prevent or slow the progression of AD in women.”
News
EU committee warns of women’s health ‘blind spot’

An EU committee has backed a report warning of systemic inequalities in women’s health research, diagnosis and treatment across Europe.
The European Parliament’s Committee on Women’s Rights and Gender Equality approved the report, which was initiated by Renew Europe.
Women remain under-represented in medical research and clinical trials.
Around 72 per cent of drug trials do not provide data separated by sex and gender, while only five per cent of global research and development funding is dedicated to women’s health.
The report was led by Renew Europe rapporteur Billy Kelleher MEP of Fianna Fáil in Ireland.
It calls for greater investment in women’s health research, stronger inclusion of women in clinical trials and gender-sensitive diagnostics and treatments, particularly for endometriosis, menopause and cardiovascular disease.
Kelleher, first vice-president of Renew Europe, said: “Women’s health remains one of medicine’s biggest blind spots.
“When research, clinical trials and medical data fail to reflect women’s experiences, the result is poorer diagnosis, treatment and care.”
The report also calls for improved access to sexual and reproductive healthcare, including follow-up to the successful European Citizens’ Initiative “My Voice, My Choice”.
Its recommendations include better support for women’s physical and mental health and access to high-quality care throughout pregnancy, childbirth and the postnatal period, free from discrimination.
It also highlights additional healthcare barriers faced by LGBTQI+ people and women in marginalised communities or vulnerable situations.
Kelleher said: “This report is about closing those gaps and ensuring that women’s health is recognised as a core measure of the quality and fairness of our healthcare systems.”
By placing women’s health higher on the political agenda, the report aims to support the implementation of the EU Gender Equality Strategy and shape future European health policies.
A final vote by the European Parliament is expected in September 2026.
Menopause
Statins may worsen menopause symptoms, study suggess

Statins have been linked to more severe menopause symptoms and a higher risk of muscle loss in postmenopausal women, a study suggests.
The medicines are among the most widely prescribed in the world, with strong evidence supporting their use to lower cholesterol and reduce cardiovascular risk.
However, some recognised side effects may resemble symptoms associated with menopause, raising questions about how the two could interact.
The US Food and Drug Administration has flagged potential adverse effects linked to statin treatment, some of which overlap with menopausal complaints.
Researchers examined data from 1,184 postmenopausal women across nine Latin American countries, assessing menopausal symptoms, sarcopenia risk and cognitive function.
They compared women taking statins with non-users after accounting for factors including age and body weight.
As the study was cross-sectional, meaning it examined information collected at one point in time, it could identify associations but could not prove that statins caused the outcomes.
Women taking statins were 56 per cent more likely to have severe menopausal symptoms than those who were not using the medicines.
The difference remained after researchers accounted for other variables.
Statin users were also 65 per cent more likely to be at risk of sarcopenia.
Sarcopenia is the gradual loss of muscle mass and physical function, which tends to accelerate after menopause.
Declining oestrogen levels already make muscle loss a concern at this stage of life. It is linked to a higher risk of falls, fractures and reduced quality of life.
Musculoskeletal symptoms were reported by 53.1 per cent of statin users, compared with 33.9 per cent of non-users.
Researchers said this was separate from the finding on sarcopenia risk and may point to a wider pattern of physical discomfort among women taking the medicines.
Women taking statins also recorded slightly lower scores in tests of delayed memory recall and visuospatial function.
Visuospatial function is the ability to understand the position of objects and their relationship to one another.
The study found no overall association between statin use and mild cognitive impairment, so the differences in individual tests are early signals rather than firm conclusions.
Researchers said effects associated with statins may overlap with menopausal symptoms and add to the overall symptom burden during midlife.
This means symptoms attributed to menopause and possible statin side effects may look similar and, in some cases, could compound one another.
Further research is needed to separate the possible effects of the medicines from symptoms linked to menopause.
The findings are not a reason for women to stop taking statins.
Their cardiovascular benefits are well established, and stopping treatment without medical guidance can carry serious risks.
The study provides more information about what statin treatment may mean specifically for postmenopausal women, who have historically been under-represented in cardiovascular research.
Women who notice more severe menopausal symptoms or changes in muscle strength or physical function while taking statins should discuss them with a doctor.
A healthcare professional may consider whether the symptoms could be related to the medication and whether screening for muscle loss is appropriate.
They may also review whether the current statin remains the most suitable option, as different statins can have different side-effect profiles.
Resistance training and consuming enough protein are well-supported ways to help preserve muscle mass during midlife.
Statins can be life-saving, but the findings suggest their possible side effects should receive greater attention in postmenopausal women.
The study adds to evidence supporting more individualised care for women during midlife.
Menopause
Hormone therapy users report healthier lifestyles

Menopausal women using hormone therapy reported healthier diet, exercise and sleep habits than non-users in a study of more than 10,000 women.
The menopause transition is associated with a higher risk of chronic health conditions and symptoms including hot flushes and problems affecting the urinary and genital systems.
Hormone therapy is often used to manage these symptoms, but it remains unclear whether it affects health outcomes directly or indirectly through changes in health behaviours.
Previous research has produced mixed results, with some studies suggesting that postmenopausal women pay greater attention to maintaining a healthy lifestyle.
The cross-sectional analysis examined whether menopause status and hormone therapy use were linked to diet, physical activity and sleep duration.
A cross-sectional study assesses participants at one point in time. It can identify associations but cannot establish whether one factor directly caused another.
Diet, exercise and sleep are described as modifiable health behaviours because people may be able to change them to improve their health.
The researchers found that postmenopausal women who had never used hormone therapy reported eating less fruit and vegetables.
Women who had never used the treatment were also 19 per cent less likely to meet guidelines for muscle-strengthening activity.
Sleep duration was shorter among postmenopausal women who had never used hormone therapy.
Compared with premenopausal and perimenopausal women, the likelihood of meeting sleep guidelines was 14 per cent lower among never-users, 26 per cent lower among current users and 24 per cent lower among past users.
Perimenopause is the transitional period before menopause, when hormone levels and menstrual periods can change.
Researchers said these findings may be linked to higher levels of follicle-stimulating hormone among postmenopausal women who do not use hormone therapy.
They may also relate to lower levels of oestradiol, a form of oestrogen, which have previously been associated with poorer sleep.
Hot flushes and urogenital symptoms can also disrupt sleep, although hormone therapy may ease these symptoms.
Dr Stephanie Faubion, medical director for The Menopause Society, said: “This large observational study underscores that women who use hormone therapy tend to adopt overall healthier lifestyles.
“Although this association may partly reflect better symptom control enabling healthier behaviours, healthy-user bias is likely a significant contributor.
“Women who choose to use hormone therapy are often more proactive in their healthcare and may systematically differ from nonusers in socioeconomic resources, access to care, and health literacy.
“This largely explains why early observational studies of hormone therapy suggested cardiovascular benefits that were not confirmed in subsequent randomised, controlled trials.”
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