The Biggest Fear
Concerns about dementia and Alzheimers’ disease are well founded as current research confirms an association of increased risk for cognitive decline with estrogen deficiency. This is not a popular topic for many clinicians and the current dominant medical paradigm of estrogen reveals significant confusion on the part of public and physicians. Avoiding the sustained adverse biology of severe estrogen deficiency is a very important area of education and careful clinical dialogue. This includes comprehensive individual risk assessment and education. Individual life style practices, especially exercise and mindfulness, nutrition, family history, genetic testing when available are important components in menopausal and pre-menopausal care and hormone support decisions.