Can menopause affect brain health? Gynaecologist reveals link between estrogen decline and Parkinson’s disease

Estrogen has a neuroprotective effect. Find out what happens after it declines and how this may show up in the form of neurodegenerative disorders risk.

Menopause is a major milestone for a woman's health. Estrogen levels drop, and menstrual cycles come to a permanent end. In other words, periods stop completely.

Women experience a sharp drop in estrogen, leading to risks of many diseases, from cardiovascular to neurodegenerative disorders. (Picture credit: Shutterstock)

Common symptoms include hot flashes and mood swings, but the impact is much more extensive because of the decline in estrogen, primarily because this hormone plays a major protective role across multiple physiological functions. Once it stops, health can begin to deteriorate.

You may have heard about the heart being affected, with a higher chance of cardiovascular-related problems. Similarly, the drop in estrogen affects the brain's neurons too.

We asked gynaecologist Dr Lakshmi Aswathaman, senior consultant, obstetrics and gynaecology at MGM Healthcare, about which neurodivergent disease women may become more vulnerable to after menopause. She said Parkinson's disease. Let's understand why this happens and whether HRT has any benefit at all.

In a study published in 2021, women who go through menopause later were found to have a slightly lower risk of developing Parkinson's disease. This also makes sense because, with late menopause, there is longer exposure to natural estrogen, which is studied to have a protective effect on the brain, and the risk of Parkinson's disease is slightly lower.

Trouble concentrating, drastic mood swings and depressive mood are common during menopause. (Shutterstock)

How does menopause affect Parkinson's disease?

The hormonal shifts caused by menopause may influence brain health and neurological conditions like Parkinson's disease (PD,)

Dr Aswathaman clinically elaborated why this happens, “Estrogen appears to have a protective effect on dopamine-producing neurons, and any drops in this hormone (e-g, during menopause or due to early hysterectomy) can increase PD risk or cause worsening of motor symptoms, increased 'off' times, and increased fatigue.”

Menopause may increase the severity of symptoms. As it is, Parkinson's is a progressive neurodegenerative disorder with no cure. Medications and therapies are aimed at regulating and managing the symptoms, but during menopause, hormonal changes occur, causing estrogen levels to drop, which further worsens the symptoms and makes management difficult.

Does HRT help?

Hormone replacement therapy (HRT) has been generally used to manage menopausal symptoms. The doctor shared insights on what it means for parkinson's, “Research has shown that hormone therapy may benefit certain symptoms associated with Parkinson's. For example, testosterone deficiency is common in older individuals and has symptoms that directly overlap with non-motor symptoms of PD that do not necessarily respond to antidepressant therapy or traditional PD therapies.”

She further elaborated how HRT works, “Two forms of bioidentical estrogen, estradiol and estriol, have a positive destabilising effect on alpha-synuclein (a-synuclein), a protein in the brain that tends to aggregate and form fibrils, or clumps, a hallmark of many neurological diseases. Generally, any postmenopausal woman or male age 50 or over can potentially benefit from hormone therapy."

It suggests how HRT could take up a complementary role in managing Parkinson ’s-related symptoms. Further, she elaborated that HRT also helps reduce fractures and muscular atrophy, lessen fatigue and depressed mood, reduce loss of libido, and increase energy and exercise tolerance.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.