Hormones Helping In Menopause

Dr. Filomena Trindade presented a talk about hormones helping in menopause. This talk was part the 26th Anti-Aging Conference of the American Academy of Anti-Aging Medicine in Las Vegas from December 13 to 15, 2018. The exact title of her talk was “Women and cognition: insulin, menopause and Alzheimer’s”. Above the age of 80 Alzheimer’s disease in women becomes much more common compared to men. PET scans of the brain of postmenopausal women in comparison to PET scans of premenopausal women, often show more than 30% slow down of metabolism after menopause. Literature regarding that finding showed that it was mostly the decline in ovarian estrogen production that was responsible for the slow down in brain metabolism. Other factors that lead to Alzheimer’s disease are central adiposity (abdominal) and inflammation in the body.

Brain insulin resistance and Alzheimer’s

Older women with Alzheimer’s have more IGF-1 resistance and IGF-1 dysfunction. Other studies showed that minimal cognitive impairment (MCI) progressing into Alzheimer’s disease (AD) might be due to type-2 diabetes. One of the studies stated the following:

“We conclude that the term type 3 diabetes accurately reflects the fact that AD represents a form of diabetes that selectively involves the brain and has molecular and biochemical features that overlap with both type 1 DM and type 2 DM.“

Another publication said that type 3 DM is a neuroendocrine disorder that represents the progression of type 2 DM to Alzheimer’s disease.

Dr. Trindade presented several hormone studies in postmenopausal women who started to develop Alzheimer’s disease. Older women with existing Alzheimer’s did not respond to estrogen hormone replacement. They did not recover with regard to their memory loss. However, younger women who just entered menopause responded well to estrogen hormone replacement and many recovered from their memory loss.

Hormone changes in menopause

There are a number of hormones that experience changes with the onset of menopause. Estrogen production ceases in the ovaries. The production of progesterone in the ovaries also ends. In addition thyroid and adrenal gland hormone production decreases. Often insulin production is increased, but insulin resistance is present at the same time.

Stress can interfere with progesterone and aldosterone production as pregnenolone is the same precursor molecule for both hormones.

How stress interferes with Selye’s general adaptation syndrome

Stage 1 of Selye’s adaptation syndrome, called arousal, involves elevation of cortisol and DHEA. When stress is over, the patient recovers on his/her own.

Stage 2 is the adaptation stage, where cortisol is chronically elevated, but DHEA is declining. The patient feels stressed, has anxiety attacks and may experience mood swings and depressions.

Stage 3 is the exhaustion stage. The underlying cause of this stage is adrenal insufficiency. Both cortisol and DHEA blood levels are low. Patients often suffer from depression and chronic fatigue.

Other hormones and menopause

DHEA and cortisol (stress) have the same precursor (pregnenolone). This means that when a patient is stressed, DHEA production tends to suffer as most of the pregnenolone is used for the production of cortisol.

Dr. Trindade spent some time explaining the complicated details of thyroid hormones during menopause. In essence stress can interfere with the normal metabolism of thyroid hormones with respect to T3, T4 and reverse T3. The end result is that not enough functioning thyroid hormones are present and hypothyroidism may develop.

Both estrogen and progesterone are lower in menopause. In a longitudinal French study with over 80,000 postmenopausal patients the women that received replacement with bioidentical progesterone and estrogen did the best in terms of low Alzheimer’s rates and lower heart attack rates. You achieve optimal Alzheimer’s prevention best starting hormone replacement at the time when menopause starts. You need both estrogen to control hot flashes and to give you strong bones, and progesterone for preservation of your brain, your hair growth and a good complexion.

Hormones Helping In Menopause

Hormones Helping In Menopause


Hormones are missing in menopause and this becomes the starting point for many postmenopausal complaints of patients. The sooner the physician does blood tests to diagnose hormone deficiencies, the better. Various studies showed that the best result in terms of Alzheimer’s prevention is possible, when estrogen and bioidentical progesterone are replaced right at the beginning of menopause. This approach prevents neuroinflammation. There are no extracellular beta amyloid protein deposits and no intracellular tau protein deposits that typically are present with Alzheimer’s disease. In addition the cardiovascular system stays healthier for longer. It contributes to preventing heart attacks and strokes. A longitudinal French study with over 80,000 women who have received treatment with a combination of estrogen and bioidentical progesterone have excellent survival data. The women also enjoy excellent mental health, no cardiovascular complications and less cancer than controls without hormone treatment.



Osteoporosis Drug Prevents Breast Cancer Recurrence

Standards in breast cancer treatment have been surgery, radiation therapy and chemotherapy. In hormone receptor positive cancer types Tamoxifen has been the drug of choice for many years to achieve suppression of the ovaries in premenopausal women. A new medication under the name of Anastrozole has also been introduced. In the meantime researchers have examined the success of the various approaches. No difference has been found between Anastrozole and Tamoxifen, but a new drug which has been used for osteoporosis patients shows that it can boost disease free survival for breast cancer patients. The medication called zoledronic acid taken in combination with either Tamoxifen or Anastrozole can increase disease free breast cancer survival by 36%. Zoledronic acid can inhibit tumor cell growth and stimulate the immune response, and the lead author of the study, Dr. Michael Gnant concludes that the combination treatment creates a tumor-hostile environment. The benefits are not only a reduction of bone metastases but others as well.

Osteoporosis Drug Prevents Breast Cancer Recurrence

The most concerning side effect is osteonecrosis of the jaw, but the researcher reported that in the trial not a single case has materialized. Other researchers, such as Dr. Martine Piccart-Gebhart , professor at the department of oncology at the University of Brussels caution that this is an important trial, but it should not be seen as a practice-changing trial. More work is needed to establish the best dosage and treatment schedule. More results from other trials investigating the combination treatment with zoledronic acid are expected this summer.

More information about breast cancer: http://nethealthbook.com/cancer-overview/breast-cancer/

National Review of Medicine, June 2008, page 18 and 19

Comment on Nov. 17, 2012: There is criticism regarding Zoledronic Acid because of osteonecrosis of the jaw and the fact that biophosphonates also have the metatasis suppressing effect. See this link.

Last edited November 4, 2014


Digital Mammography Superior For Some

Mammography has been considered a reliable screening test for breast lumps. It has become a crucial diagnostic tool for the early recognition of breast cancer. Nevertheless there are situations when the test has its limitations, which is especially true for women who have very dense breast tissue.
Dr. Martin Yaffe, PhD, a biophysics professor at the University of Toronto and Women’s College Health Sciences Center has done the groundwork for digital mammography, and 20 years of research and development have finally paid off. For women who have dense breast tissue, digital mammography will be the superior diagnostic tool, as opposed to the conventional film mammography. In a study that involved 42,760 patients who were asymptomatic both film mammography and digital mammography were used for screening. In the general study population the accuracy of the two methods was found to be similar. In the group of women under 50 years of age the digital method showed significantly more accuracy (84% vs. 69%). Accuracy for women with dense breasts was also higher with the digital method (78% vs. 68%). It also was superior for premenopausal women (82%vs.67%).

The digital equipment used was still in its development stages, and the potential of the technology will become even greater with more sophisticated equipment down the road. At this point it is not cost effective to use the digital method for all women. The digital system costs between one and a half to four times as much as the film systems.

Digital Mammography Superior For Some

Digital Mammography Superior For Some

“There is certainly no indication that digital is any less accurate than film mammography, but certainly the benefit is in a defined subgroup of women at this time,” states Dr.Yaffe. For most women film mammography remains a method that works well.

More information about breast cancer: http://nethealthbook.com/cancer-overview/breast-cancer/breast-cancer-diagnosis/

Reference: The Medical Post, October 4, 2005, page1, 62

Last edited November 2, 2014