Alzheimer disease has a sex bias: women are twice as likely as men to be affected. Studies have linked elevated follicle-stimulating hormone (FSH) levels to worsened Alzheimer disease pathology and cognitive decline in mice. Exploring the interaction of FSH with APOE4 has uncovered new aspects of Alzheimer disease. The therapeutic potential of FSH and gonadotropin-releasing hormone have also been highlighted.
This is a preview of subscription content, access via your institution
Access options
Access Nature and 54 other Nature Portfolio journals
Get Nature+, our best-value online-access subscription
$29.99 / 30 days
cancel any time
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
Andersen, K. et al. Gender differences in the incidence of AD and vascular dementia: the EURODEM studies. Neurology 53, 1992–1997 (1999).
Irvine, K., Laws, K. R., Gale, T. M. & Kondel, T. K. Greater cognitive deterioration in women than men with Alzheimer’s disease: a meta analysis. J. Clin. Exp. Neuropsychol. 34, 989–998 (2012).
Altmann, A., Tian, L., Henderson, V. W. & Greicius, M. D. Sex modifies the APOE-related risk of developing Alzheimer disease. Ann. Neurol. 75, 563–573 (2014).
Matyi, J. M., Rattinger, G. B., Schwartz, S., Buhusi, M. & Tschanz, J. T. Lifetime estrogen exposure and cognition in late life: the Cache County Study. Menopause 26, 1366–1374 (2019).
Xiong, J. et al. FSH blockade improves cognition in mice with Alzheimer’s disease. Nature 603, 470–476 (2022).
Xiong, J. et al. FSH and ApoE4 contribute to Alzheimer’s disease-like pathogenesis via C/EBPβ/δ-secretase in female mice. Nat. Commun. 14, 6577 (2023).
Urban, R. J., Veldhuis, J. D., Blizzard, R. M. & Dufau, M. L. Attenuated release of biologically active luteinizing hormone in healthy aging men. J. Clin. Invest. 81, 1020–1029 (1988).
Manfredi-Lozano, M. et al. GnRH replacement rescues cognition in Down syndrome. Science 377, eabq4515 (2022).
Wiseman, F. K. et al. A genetic cause of Alzheimer disease: mechanistic insights from Down syndrome. Nat. Rev. Neurosci. 16, 564–574 (2015).
Messina, A. et al. A microRNA switch regulates the rise in hypothalamic GnRH production before puberty. Nat. Neurosci. 19, 835–844 (2016).
Acknowledgements
The authors acknowledge the support of the European Research Council ERC-Synergy-Grant-2019-WATCH No 810331 and the ERC-2023-POC-UPGRADE No 101123221.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing interests.
Rights and permissions
About this article
Cite this article
Sauvé, F., Kacimi, L. & Prévot, V. The hypothalamic–pituitary–gonadal axis and the enigma of Alzheimer disease sex differences. Nat Rev Endocrinol (2024). https://doi.org/10.1038/s41574-024-00981-1
Published:
DOI: https://doi.org/10.1038/s41574-024-00981-1