Hormone Health Hub: Expert Insights on Testing, Balance & Better Living — menopause and executive function

Hot flashes, mood instability, brain fog and memory changes during perimenopause are not “all in your head” — but they are very much in your brain. In this in-depth clinical article, Dr. Kate Placzek of ZRT Laboratory explains how declining estradiol disrupts brain glucose metabolism, neurotransmitter signalling and thermoregulation, why perimenopause represents a window of neurological vulnerability, and why the timing of hormone replacement therapy is critical to protecting long-term brain health.

The Women’s Health Initiative (WHI) trial cast a long shadow over hormone replacement therapy — but it enrolled women well over a decade past menopause. Two newer trials, ELITE and KEEPS, specifically studied HRT started early in the postmenopausal period. Their findings on cardiovascular health, sexual function, sleep, mood and cognition paint a more nuanced and encouraging picture. Here is what the latest research shows.