The decline in estrogen during perimenopause leads to a significant 30% drop in the brain's ability to use glucose for energy. This metabolic crisis can cause brain fog and may be a key reason why women are disproportionately affected by Alzheimer's disease.
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Menopause isn't just a hormonal decline; it's a neurological renovation. The brain actively prunes pathways that supported relational, people-pleasing behaviors and builds new ones for a more independent mindset geared toward leadership. Difficult symptoms are the messy 'remodel' phase.
While the APOE4 gene is a known risk factor for Alzheimer's, its impact is sexually dimorphic. A female with two copies of the gene has a 15-fold increased risk, whereas a male with two copies has a 10-fold risk. This highlights the unique genetic vulnerability women face.
Focusing on building muscle is crucial for long-term health, particularly for women entering perimenopause. Muscle helps regulate blood sugar, reduces inflammation, and protects against osteoporosis, dementia, and heart disease, making it a vital health indicator.
While PET scans show lower glucose uptake in Alzheimer's brains, this may not be due to insulin resistance ("type 3 diabetes"). Studies show these brains can absorb glucose normally when cognitively stimulated. This suggests the issue is a lack of demand from inactive brain regions, not a failed supply mechanism.
Alzheimer's is a disease of midlife. Pathological changes in the brain start to occur from around age 30, but the first noticeable cognitive symptoms typically don't manifest until one's late 60s or 70s. This highlights a crucial, multi-decade window for prevention and intervention.
When addressing hormone imbalances, start at the base of the "hormone pyramid." Optimizing foundational hormones like cortisol (stress) and insulin (blood sugar) is essential, as they directly impact thyroid function and sex hormones like estrogen and testosterone.
It's posited that women in their late 30s and early 40s experience an intense midlife crisis. This is driven by hormonal changes and a realization they sacrificed their youth for family, leading to a period of rebellion, experimentation, and reclaiming lost time.
During menopause, the decline of estrogen also means losing its 'girl gang' of neurochemicals (dopamine, serotonin, etc.). This dissolves a lifelong 'neurochemical armor' that fueled motivation and joy, forcing you to redefine your identity and priorities without those chemical drivers.
Despite common belief, only about 3-5% of Alzheimer's cases are driven by inherited genetic mutations. The vast majority are linked to lifestyle factors like diet, exercise, and sleep, making it a largely preventable disease if proactive measures are taken early in life.
Ketones are a more efficient energy source than glucose, producing less metabolic “trash” (oxidative stress). Crucially, they can penetrate the blood-brain barrier and fuel brain cells even when they've become resistant to insulin, directly combating cognitive decline and brain fog.
