A longitudinal neuroimaging investigation published in Neurology, the medical journal of the American Academy of Neurology, demonstrates that longer lifetime estrogen exposure and hormonal therapy use are strongly tied to preserved cerebrovascular health in older women.
Researchers from the Karolinska Institutet tracked 352 cognitively healthy 70-year-old women over five years using brain MRI scans. They found that a longer reproductive lifespan was associated with an 8% reduction in cerebral small vessel disease markers, while menopausal hormone therapy cut high vascular burden risk by 59%. Women who combined past oral contraceptive use with later menopausal hormone therapy exhibited the most resilient white matter integrity and lowest vessel damage.
Cerebral small vessel disease (CSVD) represents a major vascular contributor to cognitive decline, gait impairment, subcortical strokes, and vascular dementia in aging populations. Characterized by covert microstructural pathology within penetrating arterioles and capillaries, CSVD damages white matter connectivity long before clinical neurodegeneration becomes apparent.
Epidemiological data have consistently documented that women experience disproportionately higher rates of Alzheimer’s disease and age-related dementias compared to men. While female longevity accounts for part of this gap, neuroscientists increasingly look to the lifelong biological transitions of female endocrine aging, specifically the withdrawal of 17β-estradiol during the menopausal transition, as a primary vulnerability factor.
Source: Neuroscience News — Read the full article on the original site ↗