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URMC / Obstetrics & Gynecology / UR Medicine Menopause and Women's Health / menoPAUSE Blog / November 2019 / If estradiol is an anti‐inflammatory hormone, can it protect against Alzheimer’s disease?

If estradiol is an anti‐inflammatory hormone, can it protect against Alzheimer’s disease?

Your Question: If estradiol is an anti‐inflammatory hormone, can it protect against Alzheimer’s disease?

Our Response: Dementia is described formally as progressive decline in multiple brain functions including memory, cognitive function, and reasoning. Progressive Alzheimer’s disease, characterized by loss of memory and declines in language and spatial orientation, is the cause of 60% of dementia cases. And, Alzheimer’s develops more often in women, especially in the menopause years, than men. Could this be linked to a hormone effect?

Unfortunately, nearly all scientific efforts to develop medications to block development of what was thought to be the main cause of Alzheimer’s, the deposition of amyloid in the brain, have failed. But a new concept is emerging that may link loss of estradiol to the development of Alzheimer’s for some individuals.

Normal brain function is fueled by glucose in the blood. In fact, glucose utilization by the brain constitutes 60% of the body’s use of glucose. But, glucose is delivered to certain regions of the brain via the blood vessels in the brain stem. Compromising the blood flow in the brainstem would limit the availability of glucose to the brain, but the brain has an alternative source of fuel.

The brain is capable of metabolizing lipids within the myelin, which surrounds the axons of neurons. In effect, the brain, lacking glucose, can cannibalize itself to survive but may destroy the sheath around axons in the process.

Where does estradiol come in? Estradiol is a vasodilator. Loss of estradiol in menopause could lead to vasoconstriction within the brain stem in certain individuals, thus impairing glucose transport to the brain. While still a theory, autopsy results have confirmed the breakdown of myelin in those dying of Alzheimer’s. This new theory supports focusing on a vascular cause of early Alzheimer’s in the brain stem and the possibility of early detection.

James Woods | 11/14/2019

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