Menopause and estrogen deficiency as a risk factor in dementing illness: hypothesis on the biological basis

The positive efficacy of estrogen replacement therapy (ERT) in the treatmen t of neurodegenerative disorders such as Alzheimer's disease (AD) is a matt er of intense debate among clinicians and neuroscientists. The experimental and preliminary clinical evidence supporting the use of ERT are based on e pidemiological data and on the study of the effect of estrogens on several aspects of brain homeostasis, including the modulation of neurotransmitters and vascular changes. In spite of numerous data available the mechanisms u nderlying the putative estrogen effects in neurodegenerative diseases are l argely unknown. The aim of this paper is to discuss and elaborate on some o f the hypotheses and controversial findings currently present in this field (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.