Reproductive Lifespan and Hormonal Therapy in Relation to Later-Life Neurovascular Health in Community-Dwelling Older Women: An Evidence-Based Review

Lifelong estrogen exposure correlates with reduced cerebrovascular pathology and preserved brain structure in older women, especially among APOE-ε4 carriers.
Menopausal hormone therapy (MHT) use associates with lower burden of cerebral small vessel disease and higher white matter integrity.
Endogenous reproductive factors such as longer reproductive span and older age at menopause demonstrate protective associations against Alzheimer’s disease (AD) markers.
Both endogenous and exogenous estrogen exposures influence brain aging through neurovascular and neuroprotective mechanisms, warranting further longitudinal research.

Specialty calculators

For clinical reference; use professional judgment.