Dementia Risk Linked to Age of First Period

Dementia Risk Linked to Age of First Period

A new study suggests that the age of a person’s first and last period could influence their risk of developing dementia. 

Researchers set out to assess the relationship between dementia risk and the amount of estrogen exposure, which they measured as the number of years a person menstruates. Their findings, published in the American Journal of Geriatric Psychiatry, show that people who began menstruating at a younger age or went through menopause at an older age had a reduced chance of developing future dementia. 

Dementia, which affects nearly 6 million people in the United States, refers to declining cognitive abilities, such as remembering and thinking. Alzheimer’s disease is the most common form of dementia. 

The causes of dementia are still largely unknown, but scientists have identified factors that can increase the risk of developing it, such as genes and lifestyle choices. The new study shows that not having prolonged exposure to estrogen may be another contributor.

“Based on the results of this study, estrogen might have a protective role in women in the development of dementia,” the authors wrote.

However, Suzanne Gilberg-Lenz, MD, an OB/GYN, medical advisor for Evernow, and author of Menopause Bootcamp, told Health that more rigorous research is needed to assess the connection between estrogen exposure and dementia risk.

“Ideally, future studies would include randomized controlled trials, longitudinal designs, and more precise measures of hormone levels and exposure, as well as accounting for a broader range of potential confounders,” she said.

Wilson Araujo / Getty Images.

To assess how estrogen exposure affects dementia risk, researchers analyzed information about 273,260 women aged 37 to 73 in the UK Biobank, a large biomedical database and research resource. 

Participants provided information about their reproductive histories, including the age of their first period, which is when the ovaries begin releasing estrogen, and when they first gave birth to a child. They also reported how old they were when they went through natural menopause or underwent a bilateral oophorectomy or hysterectomy—all of which would cause a drop in estrogen—and whether they ever used hormone therapy, a treatment that adds estrogen to the body.

During the study, nearly 3,700 women developed dementia. 

After crunching the numbers, the scientists found that women who started their period at age 15 or older had a 12% increased risk of dementia compared to those whose periods began when they were 12 or younger.

Meanwhile, those who went through menopause in their 50s were about 24% less likely to develop dementia than women who stopped having periods in their 40s. Participants who had a history of hysterectomy and/or bilateral oophorectomy (removal of both ovaries) had an 8% increased dementia risk.

The study is “interesting,” Marian Schuda, MD, medical director for OhioHealth John J. Gerlach Center for Senior Health in Columbus, Ohio, told Health, especially given that “for years and years, people have wondered if estrogen somehow was protective of brain cells.”

Gilberg-Lenz said the research adds to growing evidence suggesting that estrogen influences brain health. “Estrogen is not only pivotal for reproductive health but also plays a significant role in the brain, influencing cognitive functions such as memory, attention, and learning,” she said.

The anti-inflammatory effects of estrogen may be a key factor in its potential to guard against dementia, she added.

Despite the study’s results, Gilberg-Lenz said, “there’s no need to panic” if you experienced your first period on the late side or went through menopause at a younger age.

The study has several limitations, she stressed, including that it’s observational. This means it can only establish a connection between shorter estrogen exposure and increased dementia risk, but it doesn’t prove that shortened estrogen exposure causes cognitive impairment.

Additionally, “other unmeasured factors” aside from estrogen “could influence” the association between menstruation years and dementia risk, she said. The outcome could’ve been influenced by variables researchers didn’t fully account for, such as “lifestyle factors, socioeconomic or nutritional status, and genetic predispositions.”

According to Gilberg-Lenz, reproductive characteristics are only one of many factors to take into consideration when assessing your risk of developing dementia.

A family history of the condition is a more established risk factor, as is having certain health conditions, such as diabetes and high cholesterol. Your chances also rise by engaging in unhealthy lifestyle habits like smoking, drinking alcohol, and sedentary behavior. 

While some studies have shown a link between reduced dementia risk and hormone therapy, Schuda said current guidelines recommend the treatment primarily to alleviate hot flashes and other symptoms of menopause—not to stave off cognitive decline.

Gilberg-Lenz stressed the importance of regular consultations with a healthcare provider to discuss your cognitive health, including your overall risk of developing dementia. While online calculators can help you determine dementia risk, Sarah Lussier, MA, a menopause coaching specialist and personal trainer, told Health that the tools shouldn’t be used in place of a healthcare professional’s assessment and advice.

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