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The Effects of Menopause

The Longer Women Have to Live Without Estrogen, the Worse It Is for Their Heart and Brain

Does Estrogen Protect the Heart?
The sex hormone estrogen is primarily produced in the ovaries. Photo: Getty Images
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January 7, 2026, 9:55 am | Read time: 4 minutes

Estrogen plays a crucial role in a woman’s life—from the onset of puberty to menopause. And after that? What happens to a woman’s body when it no longer produces estrogen post-menopause? The short answer: a lot! During perimenopause and menopause, women experience acute symptoms of varying degrees, and after menopause, their risk for various diseases increases sharply. Coincidence? Probably not. Research increasingly suggests that estrogen has a protective effect, and its deficiency in older age is linked to unhealthy and frail later years. FITBOOK explains the current state of knowledge.

Osteoporosis and general frailty—the risk for these conditions rises sharply for women at the end of their reproductive years. Heart and brain health also often decline rapidly. Women tend to live longer than men on average, but they spend a significant portion of that time in a state requiring care. Can this be explained by the cessation of estrogen production during menopause? It’s known that estrogen deficiency is linked to bone loss. But is estrogen also important for heart and brain health—and is the menopause-induced deficiency a cause of diseases?

Also of interest: Perimenopause—More Than Half of Women Between 30 and 35 Show Symptoms

Estrogen and the Heart

Until menopause, women have a lower risk of heart disease compared to men of the same age. During menopause, the risk increases significantly and can potentially be higher than in men post-menopause. What changes? The estrogen level. According to an analysis of various studies, estrogen protects the cardiovascular system by reducing oxidative stress. In the animal experiments evaluated, the addition of estrogen significantly inhibited the development of atherosclerosis, heart failure, hypertension, and atrial fibrillation. The researchers concluded that the loss of estrogen can at least partially explain the sudden increase in heart disease risk in postmenopausal women.1

Estrogen Deficiency and Diabetes Risk

A study by UTSouthwestern in Dallas found that estrogen stimulates the cells lining blood vessels to transport insulin to the muscles. This lowers blood sugar levels and provides some protection against type 2 diabetes.2 Another study showed through animal experiments that estrogen deficiency was associated with increased insulin resistance and a higher risk of diabetes.3

More on the topic

Does Estrogen Protect the Brain?

Women are significantly more likely than men to develop dementia and Alzheimer’s.4 The reasons for this are not yet fully understood, but factors such as gender-specific differences in immune defense, blood flow, and information processing in the brain may play a role.5 However, hormones, particularly the significance of the female sex hormone, are increasingly becoming a focus of research.

A 2024 study with 273,260 female participants provided intriguing insights into the link between estrogen and dementia. It analyzed and compared the women’s estrogen exposure with their risk of dementia. Estrogen exposure is the time span between the first menstrual period and the last. Women with a longer exposure had a 28 percent lower risk of dementia than those with shorter exposure. Conversely, this could mean that estrogen has a protective effect on the brain against dementia.6

A 2023 study also explored whether estrogen protects against cognitive decline—and examined whether estrogen therapy could minimize Alzheimer’s risk in older women. Positive effects of hormone therapy were indeed observed, but only if it was initiated quickly enough after the onset of menopause—specifically within the first five years.7

Menopause—More Than Just the End of Fertility

Research increasingly indicates that menopause significantly changes a woman’s life not only in terms of fertility but also with acute, burdensome symptoms. Moreover, menopause has far-reaching consequences for the rest of a woman’s life. The estrogen deficiency characteristic of this life phase affects heart and brain health, increasing the risk of serious diseases.

This article is a machine translation of the original German version of FITBOOK and has been reviewed for accuracy and quality by a native speaker. For feedback, please contact us at info@fitbook.de.

Sources

  1. Xiang, D., Liu, Y., Zhou, S. (2021). Protective Effects of Estrogen on Cardiovascular Disease Mediated by Oxidative Stress. Oxid Med Cell Longev. ↩︎
  2. UTSouthwestern Medical Center. Study reveals how estrogen exerts its anti-diabetic effects (accessed on January 6, 2025) ↩︎
  3. Vogel, H., Mirhashemi, F, Liehl, B. et al. (2013). Estrogen Deficiency Aggravates Insulin Resistance and Induces β-Cell Loss and Diabetes in Female New Zealand Obese Mice. Hormone and Metabolic Research. ↩︎
  4. Alzheimer Forschung Initiative e.V. Frauen und Alzheimer (accessed on January 6, 2025) ↩︎
  5. Frauenportal. Weltfrauentag 2024: Warum Frauen häufiger an Alzheimer erkranken (accessed on January 6, 2025) ↩︎
  6. Park, H.K., Marston, L., Mukadam, N. (2024). The Effects of Estrogen on the Risk of Developing Dementia: A Cohort Study Using the UK Biobank Data. Am J Geriatr Psychiatry. ↩︎
  7. Ali, N., Sohail, R., Jaffer, S.R. et al. (2023). The Role of Estrogen Therapy as a Protective Factor for Alzheimer's Disease and Dementia in Postmenopausal Women: A Comprehensive Review of the Literature. Cureus. ↩︎
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