A University of Calgary study suggests that severe menopausal symptoms may be warning signs of dementia.
Dr. Zahinoor Ismail, professor of psychiatry, neurology, epidemiology and pathology at the Hotchkiss Brain Institute, said the finding comes from an ongoing cross-sectional study of the brain and aging in Canadians as part of CAN-PROTECT.
Dr Ismail related that his initial interest in the effects of menopause was sparked several years ago in his medical practice.
“I remember a case in early 2001 with a woman who presented to the emergency room with a whole host of brain symptoms, both cognitive and psychiatric. And it turned out she was right at the beginning of menopause,” he told The Canadian Press.
“So instead of treating her for these neurological and psychiatric issues, we normalized her estrogen and her symptoms disappeared. This is the genesis of this study,” mentioned Dr. Ismail.
The overall study involves 2,400 people across Canada, who are asked a number of questions about their cognition, behavior, function, health, well-being, lifestyle, diet, exercise , vitamin supplements, their medications, their medical and psychiatric problems and their quality of life.
Data from 800 of these subjects is being used to study the effects of menopause on the brain. A background paper on this data was presented at the Canadian Dementia Conference in Toronto in November. The results must be updated every year.
“We took postmenopausal women and recorded the number of symptoms they had during menopause […] So everything from those hot flashes that people talk about, to neuropsychiatric symptoms like irritability, mood swings, anxiety and then also neurocognitive symptoms like inattention and poor memory,” a- he mentioned Dr. Ismail.
“I focused on neuropsychiatric and cognitive symptoms. Because when these appear and persist in mid-life and later, they constitute risk factors for dementia.
“What we found was that the more menopausal symptoms they had, the more affected they were and the more symptoms they had,” he added.
Dr Ismail said it was also becoming clear that if menopausal women had taken estrogen therapy during menopause, they had fewer neuropsychiatric symptoms compared to those who did not take it.
Previous studies showing that hormone replacement therapy increased the risk of stroke by about a third — which later turned out to be somewhat overestimated — resulted in an entire generation of women being deprived of its advantages, he said.
“There has been a sort of rebellion for postmenopausal women to be offered hormone replacement therapy again.
“It’s clear that there is a groundswell of interest again, and that has certainly been reflected in my clinical experience and in our study data,” Dr. Ismail said.