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by carol simontacchi, cnn, ms

This Is Your Brain On Estrogen…

If you think you are losing your mind and you’re a woman, don’t lose heart. You can get it back again.

Several years ago, I lost my mind – temporarily, thank goodness. For the first time in many years, I suddenly found it difficult to concentrate. I spent my work days playing FreeCell on the computer, with work piled high around my chair. Where once I handled the ups and downs of parenting with aplomb, I suddenly found myself reacting to minor events. Life seemed too difficult to live, and I struggled with serious depression.

I examined my life; nothing had changed – except that I was inexorably drifting into peri-menopause. I made some changes to my lifestyle and supplement program – and voila! I could think again! I could focus and concentrate. I finished the book I was writing with energy to spare.

Many symptoms of menopause are mental and/or emotional in nature: anxiety, irritability, insomnia, nervousness, depression, fatigue, forgetfulness, and inability to concentrate, in addition to the purely physiological symptoms: hot flashes, insomnia, palpitations of the heart, cold hands and feet, headache, vertigo, and weight gain.

Mental and emotional symptoms can also accompany the use of oral contraceptives and hormone replacement therapy. According to the Merck Manual, common side effects of oral contraceptive use include nausea, breast tenderness, fluid retention (causing weight gain), high blood pressure, sleep disturbance, and depression. Progestogens (synthetic progesterone) produce weight gain and nervousness.

The use of estrogens cause sodium retention, producing edema; they also cause increased appetite. This list is enough to make a woman depressed, isn’t it?

But if you really want to be depressed, consider the fact that we women are using a lot of synthetic estrogens, in the form of HRT and birth control pills, prescribed by our physicians. They can be medically necessary – but they also increase weight gain and mental symptoms. Annual hormone replacement therapy prescriptions increased from 58 million in 1995 to 90 million in 1999, which represented approximately 15 million women per year. This level remained consistent through June 2002. (This does not include the amount of estrogen we ingest via estrogens in the environment, which is another huge issue.) The new oral estrogen/progestin combinations (primarily Prempro) accounted for most of this growth.

What may be changing this picture, however, is the bleak report of the Heart and
Estrogen/Progestin Replacement Study in July 2002, showing serious carcinogenic effects of the synthetic hormones, and over a 1-year period, there was a 66% drop in prescriptions for Prempro and a 33% drop for Premarin when comparing the first 6 months of prescriptions in 2002 versus 2003. (Hersh 2004)

What are the mental effects of hormone therapy? In a study of 2,808 women, researchers divided the women into two groups, one of which were given a tablet containing either 0.625 mg of conjugated equine estrogen, or a matching placebo. After five years, the Modified Mini-Mental State Examination scores were 0.26 units lower among women assigned to the estrogen compared with placebo. The adverse effects of the hormones were greater among women who began the study at lower cognitive function.

Researchers also noted that women over the age of 65 on the HRT had even more diminishing of cognitive function than younger women. That is particularly disturbing in light of the fact that the vast majority of hormone prescriptions are written for older women. (Espeland 2004)
Doctors began adding the synthetic version of progesterone, progestin, to the formula, in the hopes that it would negate some of the potential side effects of estrogen alone, but certainly in the area of mental function, the progestin is not protective against cognitive loss.

Estrogen therapy alone did not reduce the risk of dementia or mild cognitive impairment incidence and estrogen plus progestin increased the risk for both endpoints. Pooled data for estrogen alone and estrogen plus progestin resulted in an increased risk for both endpoints. Use of hormone therapy to prevent dementia or cognitive decline in women who are 65 years of age or older is not recommended. (Shumaker, 2004)

Part of the problem is not just that we tend to lose estrogen and/or progesterone as we approach menopause. We also lose the one hormone that could enhance mental ability, muscle strength, and metabolism: testosterone. Testosterone is, of course, considered a “male hormone,” but women also produce and use small amounts of this beneficial hormone that tends to dissipate with age.

Testosterone begins to wane between the ages of twenty and forty years of age. When menopausal women receive estrogen in the form of hormone replacement therapy, sex hormone-binding globulin increases, which results in a further decline of free testosterone. (Morley 2003)


about carol simontacchi, cnn, ms

Carol Simontacchi is a certified clinical nutritionist and the author of a number of books on nutrition, including Your Fat Is Not Your Fault, and The Crazy Makers: How the Food Industry is Destroying our Brains and Harming Our Children, A Woman's Guide to a Healthy Heart and her latest weight loss manual, A New Holistic You. She is also the author and designer of the weight and health management curriculum, Wings: Weight Success for a Lifetime.

She speaks to professional and lay audiences across the country on a number of topics, including weight management, fatigue, depression and other mental disorders (including autism and ASD), and children's health. She has appeared on the Maury Povich Show, The Home Page, and hundreds of other national, regional and local radio and TV shows. Her work has been featured in Newsday, First for Women, Women's Day and others.

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