Overview: Women who have undergone menopause have more white matter intensities in the brain than premenopausal women and men of the same age.
Women who have gone through menopause may have more of a brain biomarker called white matter hyperintensity than premenopausal women or men of the same age, according to a new study published in the June 29, 2022 online issue of Neurology†
White matter hyperintensities are small lesions visible on brain scans that become more common with age or with uncontrolled high blood pressure. These brain biomarkers have been linked in some studies to an increased risk of stroke, Alzheimer’s disease and cognitive decline.
“White matter hyperintensities increase as the brain ages, and while having it does not mean a person will develop dementia or have a stroke, higher amounts may increase a person’s risk,” said study author Monique MB Breteler, MD, Ph.D. , from the German Center for Neurodegenerative Diseases (DZNE), in Bonn, Germany, and a member of the American Academy of Neurology.
“Our study examined what role menopause may have on amounts of these brain biomarkers. Our results imply that white matter hyperintensities evolve differently for men and women, determining menopause or factors that determine when menopause begins, such as variations in the aging process. factors.”
The study included 3,410 people with an average age of 54 years. Of these, 58% were women and 59% of the women were postmenopausal. Also, 35% of all participants had high blood pressure and half of those had uncontrolled high blood pressure.
All participants had MRI brain scans. Researchers looked at the scans and calculated the amount of white matter hyperintensities for each participant. The mean total volume for these brain biomarkers was 0.5 milliliters (ml). The mean total brain volume was 1180 ml for males and 1053 ml for females. The mean total volume of white matter, the area of the brain where white matter hyperintensities can be found, was 490 ml for men and 430 ml for women.
After adjusting for age and vascular risk factors such as high blood pressure and diabetes, researchers found that postmenopausal women had more of these brain biomarkers compared to age-matched men. In people 45 years and older, postmenopausal women had average total white matter hyperintensities of 0.94 ml compared with 0.72 ml for men. Researchers also found that the increase in brain biomarkers accelerated with age and faster in women than in men.
Premenopausal women and men of a similar age had no difference in the mean amount of white matter hyperintensities.
Researchers also found that postmenopausal women had more white matter hyperintensities than premenopausal women of a similar age. In a group of participants aged 45 to 59 years, postmenopausal women had a mean total volume of white matter hyperintensities of 0.51 ml compared to 0.33 ml for premenopausal women.
There was no difference between postmenopausal and premenopausal women taking hormone therapy. Breteler said this finding suggests that hormone therapy after menopause may not have a protective effect on the brain.
Not related to menopausal status, women with uncontrolled high blood pressure had higher amounts of this brain biomarker compared to men.
“It is known that high blood pressure, which affects the small blood vessels in the brain, can lead to an increase in white matter hyperintensities,” Breteler said.
“The results of our study not only show that more research is needed to explore how menopause may be related to brain vascular health, they also demonstrate the need to consider different health pathways for men and women. , and the status of menopause.
“Our research underscores the importance of gender-specific medicine and more attentive therapy for older women, especially those with vascular risk factors.”
One limitation of the study was that researchers did not know the exact age of onset of menopause or whether some participants were perimenopause.
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Original research: The findings are published in Neurology