If women begin menopause at a younger age, they have a shorter reproductive lifespan (RLS), or the years from beginning menstruation to menopause). They also tend to face a more pronounced decline in cognitive abilities after menopause. Notably, women who undergo surgical menopause, or bilateral oophorectomy (removal of both ovaries—to treat ovarian cancer, endometriosis, and other conditions), before age 45 have a 70% higher risk of dementia. However, the biological mechanism to explain this relationship between earlier menopause and cognitive aging remains unknown.

Dr. Campagna will work to identify the mechanisms that manage this relationship between RLS and cognition through an investigation involving many layers of biological analysis. Working at both the tissue level and cell type-specific level, she will attempt to determine how estrogen affects gene expression in the prefrontal cortex of the brain and the RLS–cognition relationship. Her study will include and account for the differences between women exposed to menopause hormone therapy, commonly called hormone replacement therapy (HRT), and those who were not, as well as those who experienced surgical or spontaneous menopause.

This study could establish a foundation for future research that leads to new therapies to prevent or treat dementia, with or without hormonal interventions. Additionally, it could help to personalize HRT after surgical menopause. Currently, HRT is recommended for women who receive this procedure until they reach age 50, but this study could help to adjust that guidance on an individual basis to reduce the risk of associated cognitive decline.