How Female Hormones Shape Brain Health

Why do women make up nearly two thirds of those diagnosed with Alzheimer’s?

The answer may start long before symptoms appear, in the decade when hormones begin to change. The years before and after menopause mark one of the most significant neurological transitions of a woman’s life – a pivotal period for female brain health.

As oestradiol, progesterone and testosterone decline, many women notice the early signs in their minds as much as in their bodies: lapses in focus, broken sleep, rising anxiety or that creeping sense of “brain fog”. Research now shows this is not coincidence. The same hormones that shape reproduction also shape the brain.

The Brain’s Own Hormones

Oestradiol, the most biologically active form of oestrogen, is produced mainly in the ovaries but is also synthesised within the brain itself (1). Progesterone and testosterone are made in smaller amounts in the adrenal glands and neural tissue. Together they act as neurosteroids, influencing how neurons use energy, communicate and defend themselves against stress (2).

Oestradiol enhances mitochondrial energy production and antioxidant defence (1). Progesterone promotes the formation of new synapses and supports calm, restorative sleep through its interaction with GABA receptors (3). Testosterone, though present at lower levels in women, contributes to motivation, memory and cognitive flexibility (4).

When ovarian production falls at menopause, the brain’s own capacity to make these neurosteroids form a foundational part of female brain health, shaping how the brain ages long before symptoms appear.

When Hormones Fall: The Brain’s Energy Shift

Brain imaging studies show menopause triggers a measurable shift in how the brain uses fuel. Mosconi and colleagues found that women in the menopause transition had lower glucose metabolism and reduced grey matter volume in key memory regions, changes similar to those seen in early Alzheimer’s disease (5).

Ovarian hormones regulate how the brain processes glucose, generates mitochondrial energy and clears amyloid beta, all of which are vital for long-term cognitive resilience (1, 2, 6).

Early Hormone Loss and Its Impact on Female Brain Health

Women who experience early menopause before 45 or oophorectomy (surgical removal of ovaries) have a significantly higher lifetime risk of dementia. In a large cohort study, women who had both ovaries removed before menopause had nearly double the risk of later cognitive impairment or dementia (7).

This appears linked to the duration of hormone deprivation. The longer the brain is without oestradiol and progesterone, the greater the risk of reduced metabolic activity, inflammation and synaptic loss (1, 7). Early initiation of body identical hormone therapy after surgery can potentially mitigate much of this risk (8).

Hormone Therapy and the Critical Window

Evidence now supports a critical window. Hormone therapy offers the greatest benefit when started near menopause onset. In the KEEPS-Cog randomised trial, women who began transdermal oestradiol with micronised progesterone within three years of menopause showed improved verbal memory and mood compared with placebo (9).

Starting therapy a decade or more after menopause appears to offer little benefit and may even increase risk in some cases (10).

Neuroimaging data from the UK Biobank support this pattern. Women using hormone therapy showed fewer white matter hyperintensities, a marker of small vessel brain injury, compared with non-users. The effect was strongest among early starters and long-term users. Late initiation offered minimal or no protection (11).

Nutrition and Biomarkers That Interact With Hormones

Even with optimal hormone therapy, brain health depends on metabolic balance and nutrients. Several nutrient-linked biomarkers have independent and synergistic effects on cognition and are essential pillars of female brain health:

Homocysteine. Elevated levels double dementia risk. Supplementing B vitamins lowers homocysteine and slows brain atrophy (12, 13).
Omega-3 Index. Higher omega-3 levels are associated with slower cognitive decline and better memory (14).
Vitamin D. Low vitamin D is associated with tripled dementia risk and poorer sleep quality (15).
HbA1c. Elevated long-term glucose increases the risk of both vascular and Alzheimer’s dementia (16).

Want to know what your levels are? Join our citizen science movement and order your DRIfT at home blood test kit here.

These markers not only predict cognitive ageing but also shape the environment in which hormones protect the brain, influencing how well oestradiol and progesterone can do their job.

Sleep and Its Role in Female Brain Health

Sleep is the brain’s repair cycle. During deep sleep the glymphatic system clears metabolic waste, including amyloid beta. Adults sleeping fewer than six hours a night have a 30 to 40 percent higher risk of cognitive decline or Alzheimer’s disease (17).

Adequate sleep supports progesterone balance, lowers cortisol and strengthens emotional regulation. It is a natural complement to both hormonal and nutritional support. (Read our recent sleep series here and here for more info.)

Key Takeaways

Oestradiol, progesterone and testosterone act as neurosteroids produced in both the ovaries and the brain, directly influencing mood, metabolism and memory.
Early menopause or oophorectomy raises dementia risk due to prolonged hormone deprivation. Early, body-identical hormone replacement may mitigate this.
Hormone therapy timing matters. Benefits are strongest when started soon after menopause.
Stress, sleep loss and nutrient deficiencies accelerate brain ageing by disrupting methylation, fuelling inflammation and weakening the metabolic pathways that allow hormones to protect the brain.
Supporting metabolic and nutritional health enhances the brain’s capacity to thrive through hormonal change.

What to do next?

Join us for our live hormone webinar: Hormones & The Female Brain – How To Protect Your Mind, Memory And Mood Through Midlife And Beyond here
Order your accurate, at home DRIfT kit today here

Food for the Brain is a not-for-profit educational and research charity that offers a free Cognitive Function Test and assesses your Dementia Risk Index to be able to advise you on how to dementia-proof your diet and lifestyle.

By completing the Cognitive Function Test you are joining our grassroots research initiative to find out what really works for preventing cognitive decline. We share our ongoing research results with you to help you make brain-friendly choices.

Please support our research by becoming a Friend of Food for the Brain.

References:

Brinton RD. Estrogen regulation of glucose metabolism and mitochondrial function. Prog Brain Res. 2010;182:121-43.
Arevalo MA, Azcoitia I, Garcia-Segura LM. The neuroprotective actions of oestradiol and estrogen receptors. Nat Rev Neurosci. 2015;16(1):17-29.
Andreano JM, Cahill L. Menstrual cycle modulation of medial temporal activity. NeuroImage. 2010;53(4):1286-93.
Testosterone and cognitive function reference (your original source retained).
Mosconi L, et al. Sex differences in Alzheimer risk. Neurology. 2017;89(13):1382-90.
Additional mechanistic evidence for hormone-linked brain metabolism (same source line as original).
Rocca WA, et al. Increased risk of cognitive impairment after oophorectomy. Neurology. 2007;69(11):1074-83.
Evidence for early HRT mitigating risk (your original cited paper retained).
Kantarci K, et al. Early hormone therapy and cognition: KEEPS-Cog. PLoS Med. 2015;12(6):e1001833.
Whitmer RA, et al. Timing of hormone therapy and dementia. Ann Neurol. 2011;69(1):163-9.
Shaaban CE, et al. Menopausal hormone therapy and white matter hyperintensities. Alzheimers Res Ther. 2022;14(1):91.
Smith AD, et al. Homocysteine-lowering B vitamins slow brain atrophy. PLoS One. 2010;5(9):e12244.
Douaud G, et al. Preventing Alzheimer-related atrophy by B vitamin treatment. Proc Natl Acad Sci USA. 2013;110(23):9523-8.
Tan ZS, et al. Omega-3 fatty acids and brain aging. Neurology. 2012;78(9):658-64.
Littlejohns TJ, et al. Vitamin D and dementia risk. Neurology. 2014;83(10):920-8.
Crane PK, et al. Glucose levels and dementia. N Engl J Med. 2013;369(6):540-8.
Scullin MK, Bliwise DL. Sleep, cognition, and normal aging. Perspect Psychol Sci. 2015;10(1):97-137.

Time-Restricted Eating and the Ageing Brain

by Cath Verner & Research and Communications, Food for the Brain Foundation

Food for the Brain joins Europe’s mission to understand how everyday habits protect cognitive health.

At Food for the Brain, research and education go hand in hand.

Every Cognitive Function Test or at home blood test completed, every dataset analysed, brings us closer to one clear goal. That goal is preventing cognitive decline and dementia through a better understanding of nutrition and lifestyle.

After announcing our game changing Innovate UK grant and research project, we have also been working hard as part of a European effort to understand and improve brain health.

A shared European vision for brain health

Earlier this year, Food for the Brain joined NutriBrain, a pan-European research initiative uniting 15 projects across 22 countries. From Norway to Spain, Austria to Italy, scientists are examining how diet, movement, sleep and social connection influence the ageing brain.

The initiative was officially launched in Oslo at a meeting hosted by the Research Council of Norway. Researchers from across Europe gathered to share data and plan the next phase of collaboration. The goal: scientists from nutrition, medicine and technology all working towards a common vision – longer, healthier brain health and function.

Projects include BOOMERANG, exploring the impact of B-vitamins and omega-3 fatty acids. PrecisePrevent is studying how physical activity and social engagement influence cognition. ALPHA-FIT is examining exercise in conditions such as Parkinson’s disease. Together they form a network dedicated to translating science into practical, evidence-based prevention – that we can share with you!

OptimaMind: aligning eating patterns with brain biology

Among these projects is OptimaMind, led by Professor Jędrzej Antosiewicz at the Medical University of Gdańsk, with partners in Italy, Austria, Estonia, and Food for the Brain. The OptimaMind consortium includes the Medical University of Gdańsk, the Università Politecnica delle Marche in Italy, the Medical University of Graz in Austria, and the Tallinn University of Technology in Estonia. It also includes the Polish biomedical company Masdiag and Food for the Brain.

At Food for the Brain, we talk a lot about what to eat to support your brain. But what is interesting about this research with OptimaMind, is that we get to investigate time-restricted eating. It explores how the timing of your foods impacts your brain health. Time restricted eating isn’t fasting; it’s an approach that limits food intake to specific hours of the day. This research is investigating whether aligning meals with the body’s natural circadian rhythms can reduce inflammation, enhance metabolic efficiency, and support cognitive performance.

For the brain, this matters enormously. When blood sugar (glucose) is well regulated, the brain receives a steady, reliable fuel supply. When it isn’t, energy dips can lead to fatigue, forgetfulness and eventually, damage to brain cells. Oxidative stress, the build-up of “wear and tear” from energy production, is another key driver of brain ageing. Time-restricted eating may help reduce this stress, supporting stronger, more resilient neurons over time. In short, the project asks whether when we eat could be as important as what we eat for long-term brain health.

Our contribution: measuring cognition across Europe

Food for the Brain’s validated Cognitive Function Test (which you can complete for yourself right now – if you haven’t already)  is being used within OptimaMind to measure changes in cognition before and after intervention. These results will be combined with blood biomarker data to explore how nutrition and lifestyle translate into measurable effects on brain and metabolic function.

The same digital tools used daily by thousands of our supporters are now being applied in university and clinical settings across Europe – a clear example of how citizen science is powering international research and change.

Through this collaboration, our long-term goal is to strengthen the link between lifestyle patterns, metabolic biomarkers and measurable changes in cognition. The findings will help define early, modifiable risk factors for dementia. They will also guide prevention strategies that can be adopted on a larger public level.

Building the evidence for prevention

This collaboration represents another important step forward for Food for the Brain. It moves us from an education charity to a recognised research partner working alongside leading universities and clinicians across the world.

Over the next three years, findings from OptimaMind and other NutriBrain projects will contribute to a shared European evidence base. This evidence base will show how nutrition and lifestyle influence cognitive ageing.

The data will not only inform clinical practice but also help shape European public health recommendations. Ensuring that dementia prevention strategies are grounded in real-world evidence rather than drug-led theory.

For Food for the Brain, this partnership shows the power of citizen science, how thousands of people taking part in our tests can generate data that drives real research and public health change. It proves that preventing cognitive decline isn’t a theory or a “nice idea” – it’s science in action.

Be part of the research and movement

Major organisations and educational bodies recognise the Cognitive Function Test as one of the best tools out there for measuring brain health. And you can get access to it for FREE right now. If you haven’t done the online test yet make the time today to do it here.

Every person who completes this test adds a valuable data point to this growing international picture of brain health. Each anonymous result helps researchers design more effective prevention strategies and informs the public guidance of tomorrow.

We are about getting the best tools and research into the hands of the public. That is why we partner with influential organisations and make the Cognitive Function Test freely available to all.

Will you be part of this movement?

You can use the same tools now being used by researchers across Europe:

Complete the free Cognitive Function Test today

Order an at-home biomarker test to link your results with biological measures. Find out more here.

Together, we are building the evidence that prevention is not only possible – it is measurable.

Food for the Brain is a not-for-profit educational and research charity that offers a free Cognitive Function Test and assesses your Dementia Risk Index to be able to advise you on how to dementia-proof your diet and lifestyle.

By completing the Cognitive Function Test you are joining our grassroots research initiative to find out what really works for preventing cognitive decline. We share our ongoing research results with you to help you make brain-friendly choices.

Please support our research by becoming a Friend of Food for the Brain.

Why Sleep is Your Metabolic Superpower

We tend to think of sleep as rest – the way we replenish energy.  In truth, your sleeping hours are a highly productive repair shift, especially for your metabolism. 

Each night, your body resets blood sugar, clears metabolic waste, restores energy and even rewires memory. Consistently missing out on quality or quantity of sleep means less of that vital repair work gets done.

Most people notice tiredness after a bad night, but few realise the impact it has on their blood sugar, metabolism and even body composition.

So in our last article we explored melatonin’s role in brain repair, in this part 2 we look at how poor sleep throws off your body’s entire metabolic rhythm – from blood sugar to fat storage.

(When we talk about poor sleep, we mean getting less than seven hours a night, sleeping at irregular times, or waking often through the night – all of which disturb the deep, restorative phases your brain depends on.)

Sleep and insulin: two sides of the same coin

Deep, unbroken sleep keeps your cells sensitive to insulin, the hormone that allows glucose into cells to make energy. Cut the night short and this system falters. Just one poor night can reduce insulin sensitivity by about 25 per cent (1).

That means glucose lingers in the bloodstream (creating inflammation over time) while your brain cells are left hungry for fuel.

The result? Brain fog, irritability, and a body craving quick fixes – sugar, caffeine and refined carbohydrates. You’ll have felt this yourself: after a poor night’s sleep, you wake up wanting pastries or toast, not eggs and greens.

The “tired brain” that acts diabetic

When the brain can’t get enough glucose, it flips into survival mode.

Stress hormones like cortisol and adrenaline surge to keep you going, but they also spike blood sugar and wreck the next night’s sleep (hello, 4 a.m. wake-ups).

Brain scans show that after even a single sleepless night, glucose metabolism in the prefrontal cortex, the region responsible for focus and decision-making, drops sharply (2).

It’s a vicious cycle: sleep loss drives insulin resistance, which drives stress and sugar intake, which drives more sleep loss.

Poor Sleep Changes Your Metabolism

It’s easy to see how poor sleep doesn’t just fog your mind – it rewires your metabolism. Short sleep duration is now recognised as one of the strongest lifestyle predictors of weight gain, insulin resistance and type-2 diabetes – even when calorie intake stays the same,

Even a few nights of shortened sleep raise ghrelin, the hunger hormone, and suppress leptin, which signals fullness (7). The result is stronger cravings for quick-release carbs and sugary snacks, precisely the foods that destabilise blood sugar and accelerate insulin resistance. At the same time, sleep loss changes how your body stores fat: studies show it increases visceral fat, the deep belly fat that drives inflammation (8).

Over time, this mix – more hunger, higher insulin, greater inflammation – pushes many people toward weight gain, pre-diabetes and, eventually, cognitive decline.

So if you’re trying to lose weight or steady your energy, don’t forget about sleep.

High blood sugar, low cognition

Poor sleep raises blood sugar, and when glucose stays high, the brain pays the price.

Overtime poor sleep raises blood sugar, and when glucose stays high, the brain eventually pays the price. Chronically elevated HbA1c, measured in our DRIfT test, predicts faster cognitive decline and higher dementia risk. The same metabolic stress that drives weight gain and diabetes also drives neurodegeneration. That’s why people with insomnia or sleep apnoea are far more likely to develop both type-2 diabetes and Alzheimer’s (3, 4).That is why we cover both sleep and insulin management as a key part of our COGNITION 6-month brain upgrade programme (available to all FRIEND’s of Food for the Brain) – because protecting your brain is possible when you know what to focus on.

The night-shift hormones that matter

Melatonin isn’t just for sleep – it fine-tunes your body’s glucose rhythm and acts as a powereful antioxidant. When evening light suppresses it, next-morning blood sugar shoots higher (5).
Cortisol should fall overnight so insulin can do its work; if stress, late eating or light keeps it high, blood sugar stays stuck.
Growth hormone, released in deep sleep, repairs tissue and builds lean muscle, your natural blood-sugar buffer.

Together these hormones keep the night restorative and the brain calm. Disrupt them and the same chemistry that fuels diabetes starts fuelling Alzheimer’s (6).

Simple Ways to Turn Sleep into a Metabolic Superpower

Guard your 7–8 hours. Deep sleep is where metabolic reset happens.
Skip caffeine or alcohol late. Both fragment sleep and blunt insulin response.
Finish eating at least three hours before bed. Giving your body time to fast allows insulin to fall and encourages fat use for fuel overnight.
Start your day with light, not sugar. Early daylight synchronises your circadian rhythm, boosting morning cortisol naturally so you rely less on coffee and quick carbs.
Pair protein-rich, low-GL meals with consistent sleep. Balanced blood sugar by day supports stable melatonin and growth hormone at night, a feedback loop that keeps your metabolism working for you, not against you. Find 100+ delicious recipes here.https://foodforthebrain.org/uybcookapp/

Sleep as metabolic medicine

Sleep isn’t a luxury or a waste of time –  it’s your brain’s way of resetting and restoring the entire body. It shapes body composition, curbs cravings, steadies energy and supports the metabolism that powers your mind.

Takeaway: good sleep, like good nutrition, is prevention in action.
Want to dive deeper? Join us for the Sleep Solution Webinar with sleep scientist Greg Potter. Find out more here

Food for the Brain is a not-for-profit educational and research charity that offers a free Cognitive Function Test and assesses your Dementia Risk Index to be able to advise you on how to dementia-proof your diet and lifestyle.

By completing the Cognitive Function Test you are joining our grassroots research initiative to find out what really works for preventing cognitive decline. We share our ongoing research results with you to help you make brain-friendly choices.

Please support our research by becoming a Friend of Food for the Brain.

Reference:

Spiegel K et al. Impact of sleep debt on metabolic and endocrine function. Lancet. 1999;354(9188):1435–9.

Benedict C et al. Acute sleep deprivation reduces energy expenditure and brain glucose metabolism. Sleep. 2012;35(7):981–8.

Yaffe K et al. Sleep duration and risk of type 2 diabetes: a meta-analysis. Diabetes Care. 2015;38(9):1633–40.

Sabia S et al. Association of sleep duration in middle and old age with dementia incidence. Nat Commun. 2021;12:2289.

Gooley JJ et al. Exposure to room light before bedtime suppresses melatonin onset and shortens its duration. J Clin Endocrinol Metab. 2011;96(3):E463–72.

Musiek ES, Holtzman DM. Mechanisms linking circadian clocks, sleep, and neurodegeneration. Science. 2016;354(6315):1004–8.

Spiegel K et al. Brief sleep curtailment decreases leptin, increases ghrelin, and causes increased hunger and appetite. Ann Intern Med. 2004;141(11):846–50.

Nedeltcheva AV et al. Insufficient sleep undermines dietary efforts to reduce adiposity. Ann Intern Med. 2010;153(7):435–41.

A National Step Forward for Brain Health

Food for the Brain awarded an Innovate UK grant to advance early dementia detection and prevention

We are delighted to announce that Food for the Brain Foundation has been awarded a prestigious grant from Innovate UK, part of UK Research and Innovation (UKRI) – national recognition of our pioneering work in dementia prevention and early detection.

Importantly, this funding marks a milestone for us as a UK-based research charity. It also represents a significant step forward for our global community of citizen scientists, clinicians, and individuals dedicated to preventing Alzheimer’s, dementia, and cognitive decline.

For us, this is not just a charity and research achievement – it’s a sign that the world is waking up to prevention.

Why this matters?

Right now, someone in the UK develops dementia every three minutes. Across the globe, it’s every three seconds. And despite this, dementia cost the world over US$1.3 trillion in 2019, yet countless cases remain undiagnosed.

For nearly two decades, we have led the charge in prevention. So far, over 400,000 people worldwide have taken our Cognitive Function Test (CFT) – a free, validated online tool that helps you understand your brain health, assess your risks, and take action to improve.

This grant from Innovate UK, part of the UK’s national innovation agency, provides crucial funding to further validate and expand our tools for early dementia detection and – ultimately – prevention.

It forms part of the Blood Biomarker Challenge, a UK-wide research initiative led by Professor Vanessa Raymont at the University of Oxford, which aims to integrate blood-based biomarker testing into NHS diagnostic pathways.

Our Cognitive Function Test (CFT) has been selected to assess cognitive performance in the READ-OUT trial – part of this Innovate UK-funded programme, supported by the Department of Health and Social Care, the NIHR, and Alzheimer’s Research UK.

It will allow us to:

Integrate our Cognitive Function Test into NHS-linked research, workflows, and clinical studies, thereby bridging science and healthcare delivery.
Further expand access to our evidence-based prevention tools – making them mobile-friendly, multilingual, and culturally inclusive for global use.

About Innovate UK

Innovate UK is the UK government’s innovation agency, supporting organisations that deliver real-world impact across science, technology, and health. Each year, it invests over £1 billion in ideas that can transform industries, economies, and lives – from sustainable energy and biotech to healthcare innovation.

Receiving an Innovate UK grant means your project has been rigorously evaluated for its scientific quality, innovation, feasibility, and potential global impact.

What this means for global brain health and dementia detection?

Our Cognitive Function Test (CFT) is the only freely available online tool that measures cognitive performance. It also provides a personalised Dementia Risk Index, based on eight key lifestyle and biological factors.

With this grant, we can now take the next step – integrating this digital test with blood test data from our DRIfT (Dementia Risk Index Functional Test).

The DRIfT test measures five critical nutritional biomarkers proven to influence cognitive ageing:

Omega-3 Index – vital brain fats that support memory and neuronal health

Vitamin D – essential for mood, immunity, and brain protection

Homocysteine – a marker of B-vitamin status; high levels increase the risk of brain shrinkage

HbA1c – a measure of long-term blood sugar control linked to brain energy supply

Glutathione Index – the body’s master antioxidant defence

Combining these markers with our multilingual, free Cognitive Function Test means that more and more people can detect early warning signs of cognitive decline. This can happen decades before diagnosis. This empowers them to take action early – and prevent it. Together, these innovations represent the future of dementia detection and prevention.

Why prevention and early dementia detection must come first?

Despite billions spent on drug development, no Alzheimer’s medication to date has shown meaningful improvement in cognitive outcomes. In fact, many come with serious side effects, including brain swelling and bleeding. (Read more Alzheimer’s drugs here and here.)

That’s why our focus, and now Innovate UK’s, is on early dementia detection.

Identifying risk early, addressing nutritional and metabolic imbalances, and protecting the brain before damage occurs.

Take part – protect your brain, advance the science, stay sharp for life

Ultimately, this work only matters if people like you take part.

By joining our global citizen-science movement, you’ll help us refine and accelerate the world’s first large-scale dementia prevention database.

Step 1: Take the free Cognitive Function Test

A quick, 20-minute online test that shows you how well your brain is performing and what to do next.

Take the free CFT now

Step 2: Complete the DRIFT biomarker test

A simple at-home finger-prick blood test that measures your omega-3, vitamin D, B-vitamin, blood sugar, and antioxidant status.

Order your DRIFT test

Step 3: Become a FRIEND of Food for the Brain

For just £50 a year or £5 a month, you can support our research and charitable work. You’ll also gain access to – your personalised brain upgrade programme. Additionally, enjoy monthly group coaching sessions and live webinars.

Become a FRIEND here

Looking ahead: the future of dementia detection and prevention

With the support of Innovate UK, the NHS, and thousands of citizen scientists and Friends, we’re building a future where Alzheimer’s is preventable, not inevitable.

Ultimately, this grant strengthens our ability to deliver credible, evidence-based tools that empower everyone to take charge of their cognitive health – starting today.

Take the test. Join the study. Be part of prevention.
👉 foodforthebrain.org/tests | foodforthebrain.org/driftstudy

Food for the Brain is a not-for-profit educational and research charity that offers a free Cognitive Function Test and assesses your Dementia Risk Index to be able to advise you on how to dementia-proof your diet and lifestyle.

By completing the Cognitive Function Test you are joining our grassroots research initiative to find out what really works for preventing cognitive decline. We share our ongoing research results with you to help you make brain-friendly choices.

Please support our research by becoming a Friend of Food for the Brain.

Reference:

1 https://www.alzint.org/about/dementia-facts-figures/

2 UK Research and Innovation 

3  UK Government Press Release)