Alzheimer's disease in women: supporting the research of Professor Michael Craig

Two thirds of people living with Alzheimer's disease are women. The changes in the brain that lead to the disease begin in midlife, around the years of the menopause, and for decades the explanation has centred on falling oestrogen. I believe other hormonal changes at the menopause deserve far more attention than they have received. I am raising £250,000 to support my research programme at King's College London on hormones, brain health and healthy ageing in women.

The question nobody has answered

Women live longer than men, but that does not fully explain why so many more women develop Alzheimer's disease. Something about the menopausal transition appears to matter.

The idea that loss of oestrogen is responsible has shaped a great deal of modern medicine and research funding. Yet the number of women living with Alzheimer's disease, osteoporosis and heart disease continues to rise. The story is missing a chapter.

The hormone that goes up

At the menopause, oestrogen falls. Another hormone, follicle stimulating hormone or FSH, does the opposite. It begins rising during the perimenopause, often years before the last period, rises further afterwards and remains elevated for decades.

FSH was long assumed to act only on the ovaries. Research over the past few years, including a study published in Nature in 2022, suggests it does considerably more. In that work, raised FSH acted directly on brain cells and accelerated the accumulation of the proteins that characterise Alzheimer's disease. Blocking FSH improved memory and reduced the damage. Earlier studies from the same group found that blocking FSH also protected bone and reduced body fat. Together these findings raise the possibility that one hormone contributes to three of the conditions that most affect women after the menopause.

These findings come from laboratory and animal studies and have not been shown in women. Finding out whether they apply to women is the kind of question my research sets out to answer.

One approach my team is exploring

The American team behind this work has shown that antibodies against FSH can reverse disease processes in animals. Antibody treatment, however, is expensive and has to be given repeatedly, which makes it impractical as something a woman might take for 30 years to prevent a disease she does not yet have.

One direction my research is exploring is whether the body could be prompted to make its own blocker. A small injection would deliver temporary genetic instructions, using the same class of mRNA technology as the recent generation of vaccines. The body would produce the blocking antibody for a limited period and then stop, with no permanent change to its genes. If this proved safe and effective, it could be less expensive, easier to adjust and simple enough to give in a clinic rather than a hospital. This work is at an early stage and is one of several questions that donations to the programme will support.

This is not an argument against HRT

Hormone replacement therapy is effective for menopausal symptoms and remains the right treatment for many women. Nothing on this page suggests otherwise, and nobody should stop or change their treatment because of it.

HRT is used mainly to relieve symptoms and protect bone, and it has not been shown to prevent dementia. Many women cannot take it, including many with a history of breast cancer, and its benefits fade once it is stopped. If rising FSH causes harm in its own right, replacing oestrogen alone was never going to be the whole answer.

Why I am asking for your help

Most research on women's brain health has focused on oestrogen, and I am challenging that consensus. Conventional grants rarely fund early work of this kind until evidence already exists to support it. Philanthropic funding allows new ideas to be tested rigorously at the stage where they are most easily overlooked, and the evidence it produces is what later attracts larger investment.

How the funding will be used

Your donation will support my research at King's on hormonal change, brain health and healthy ageing in women. This includes laboratory work, research staff, specialist equipment, data collection and analysis, and new collaborations with colleagues in neuroscience, psychiatry, reproductive health and dementia research.

Every gift is used for this work, whatever total the appeal reaches. Regular monthly giving is particularly valuable because it allows research to be planned with confidence rather than pursued in short funding cycles.

Who I am

I am Professor of Translational Reproductive and Neurodevelopmental Sciences at the Institute of Psychiatry, Psychology and Neuroscience, King's College London, and a consultant psychiatrist in the NHS. I am the only academic psychiatrist in the UK with dual specialist training in psychiatry and in obstetrics and gynaecology. That combination is why I keep returning to questions that fall between specialties and are overlooked as a result.

My work on hormones and the brain began more than 20 years ago with studies of the menopause, hormone therapy and cognition. I founded and led the National Female Hormone Clinic, a tertiary NHS service for women whose mental health problems are driven by hormonal change. The clinic has treated thousands of women and helped shape national guidance. I have published more than 100 papers in peer reviewed journals and have led large multicentre research programmes in the UK and across Europe. Advances in science and technology now make it possible to investigate questions I first raised two decades ago.

Where your money goes

Donations are paid to King's College London, an exempt charity under Schedule 3 of the Charities Act 2011, and held in a restricted research account for my work. Funds cannot be withdrawn as cash. They are spent only through the university's finance system against invoices and costed staff time, with the same oversight as any research grant. If you are a UK taxpayer, adding Gift Aid increases your donation by 25% at no cost to you.

If you are considering a larger gift, please contact Christopher Demetriou, Head of Leadership Giving at King's, at christopher.demetriou@kcl.ac.uk.

If you are one of my patients

Please treat this page as information rather than a request. Whether or not you give has no bearing on your care, and I will not raise it during appointments. Your treatment and this research are separate, and I intend to keep them that way.

What this could mean

The ambition is to stop regarding the menopause as the start of a decline and to treat it instead as the moment to intervene, so that women stay mentally sharp, physically strong and independent for decades longer. That is a large claim resting on early science, and it may prove wrong, or only partly right, in women. Testing it properly is the only honest way to find out, and that is what your support would pay for.