2nd World Congress on
Primary Healthcare and Medicare Summit

Biography:

Consultant of  obstetrics and gynecology (1991), PhD (2002); Habilitated Professor of obstetrics and Gynecology, and Head of “Dr I Cantacuzino” Discipline of obstetrics and gynecology , at “Carol Davila” University of Medicine and Pharmacy, Bucharest (2016), President of   The Romanian  Menopause Medical Association (June 2019) with active involvement in women’s health research and care, from the entrance in the speciality., with focus on hormonal contraceptive methods, non-oral routes for menopausal hormone therapy, gynecological conservative surgery, besides maternal-fetal medicine.

Abstract:

Endocrine and neural senescence overlap in time, by  intertwined complex feedback loops. Women’s brain  is more prone to suffer  during life,  perimenopause is a ”critical period”, offering to the scientific and medical communities a  “critical window of opportunity” to delay the onset of brain aging and neurodegenerative diseases, Alzheimer’s disease(AD) being actually the most analyzed. Women’s brain exposure to estrogens from puberty during reproductive years is crucial for the  brain health in elder ages, different from populations. Depression associated to memory, learning, cognition disorders are present from earlier ages when hysterectomy with/without adnexectomy vs general population. The multifactorial  nature of women’s brain aging opens many hypotheses and tests in health research and practice.  AD is  characterized not only by Aβ oligomers, plus fibrils accumulation, but also by metabolic and inflammatory changes, with onset in transition, and early years of menopause. Animals models are helpful to sustain the still controversial results of human clinical  observational/randomized controlled trials. Deep analysis of endocrine, neural, metabolic pathways are giving new insights to the sequential view of Aβ-centric in AD pathogenesis, prevention and treatment from  perimenopause, for maintaining women’s neurological health, to maintain brain volume, proved to diminish. Estrogens, progesterone and androgens, with nuclear and membrane receptors, genes, and epigenetics, their connections to cholinergic, GABAergic, serotoninergic, and glutamatergic systems are involved in women’s brain normality or pathology through direct/indirect mechanisms of modulating/protecting plasticity, vessels net-work, fuel metabolism- glucose, ketones, ATP, insulin resistance, aging brain’s inflammation through  blood-brain-barrier disruption, and microglial aberrant activation, neural cell survival/loss, în myelination, and influences on congnitive processes. Estradiol protects the neurons from excytotoxic damage and increases neuronal survival. Progesterone with it’s 5α-reduced metabolite, allopregnanolone stimulates neurological and functional recovery, different from progestagens.  Androgens also exhibit a wide array of neuroprotective effects in motoneurons, including supporting cell survival, axonal regeneration, and dendritic maintenance.