Wall Street Journal
March 25, 2008

HEALTH JOURNAL
By MELINDA BECK

March 18, 2008; Page D1

Gayatri Devi was a neurologist and psychiatrist specializing in memory
disorders when a patient’s case changed her career. The 52-year
Brazilian woman, once a dynamo, had become forgetful and disoriented.
Dr. Devi and her colleagues diagnosed early Alzheimer’s disease and
prescribed a standard AD drug. As an afterthought, Dr. Devi added
estrogen, having seen research suggesting it might slow the dreaded
disease.

Six months later, the woman returned and insisted she was cured. “I
didn’t believe it, but we tested her and her symptoms had resolved,
thanks to the estrogen,” says Dr. Devi. “That was the beginning of my
journey.”

ESTROGEN CONNECTION

For more information on estrogen and memory, see:
* “Estrogen, Memory & Menopause” by Gayatri Devi, M.D.
* “It’s My Ovaries, Stupid” by Elizabeth Lee Vliet, M.D.
* www.nymemory.org: Dr. Devi’s New York Memory and Health Aging Services
* www.Herplace.com: Dr. Vliet’s informational siteIn the 10 years since,
Dr. Devi has treated several hundred patients for menopause-related
memory loss in her New York City practice. Many are professional women
who find they can’t summon up words or lose track of what they were
doing. Some are afraid to tell anyone, some have been dismissed as
simply stressed. And some are still years away from menopause; the
hormonal ups and down are often more pronounced in “perimenopause,”
which can start as much as seven years earlier.

“They’re terrified they are developing Alzheimer’s disease,” says Dr.
Devi. “But the majority of them do respond to estrogen.”

Other doctors who specialize in menopause say such cognitive problems
are just as common as hot flashes and often more worrisome. “Women have
been telling me this for 25 years,” says Elizabeth Lee Vliet, a women’s
health physician with offices in Tucson, Ariz., and Dallas, Tex., who
notes that her patients often speak of feeling “fuzzy-headed.” She takes
detailed blood tests and typically prescribes 17-beta estradiol, an
FDA-approved estrogen replacement. “They come back a couple weeks later
and say ‘It was like someone turned a light bulb on my brain! I can think
again!’ ”

The phenomenon isn’t surprising considering that there are estrogen
receptors throughout the brain, particularly in the areas that govern
learning, memory and mood. Estrogen also stimulates the growth of
dendritic spines that enable nerve cells to communicate, and increases
the level of neurotransmitters, the brain’s chemical messengers In
addition, estrogen helps regulate glucose, inflammation and antioxidants
in the brain. Neuroimaging studies have shown that when estrogen
declines, there is markedly less cerebral blood flow and activity.

Men’s brains function differently. A 2005 study from the University of
California at Irvine found that men rely much more heavily on gray
matter, the information-processing centers in the brain, while women
utilize more white matter, which provides networks between the
processing centers. In short, women’s brains make more connections.
“Women remember word for word what somebody said yesterday, or last
year,” says Dr. Devi. But men’s brains also require estrogen, which is
converted from testosterone. In fact, because men continue to make
testosterone all their lives, a 72-year old man typically has more
estrogen than a 72-year old woman.