The peri-menopause or menopausal transition—the time period that surrounds the final years of a woman’s reproductive life—is associated with profound reproductive and hormonal changes in a woman’s body and exponentially increases a woman’s risk of cerebral ischemia and Alzheimer’s disease. Although our understanding of the exact timeline or definition of peri-menopause is limited, it is clear that there are two stages to the peri-menopause. These are the early menopausal transition, where menstrual cycles are mostly regular, with relatively few interruptions, and the late transition, where amenorrhea becomes more prolonged and lasts for at least 60 days, up to the final menstrual period. Emerging evidence is showing that peri-menopause is pro-inflammatory and disrupts estrogen-regulated neurological systems. Estrogen is a master regulator that functions through a network of estrogen receptors subtypes alpha (ER-α) and beta (ER-β). Estrogen receptor-beta has been shown to regulate a key component of the innate immune response known as the inflammasome, and it also is involved in regulation of neuronal mitochondrial function. This review will present an overview of the menopausal transition as an inflammatory event, with associated systemic and central nervous system inflammation, plus regulation of the innate immune response by ER-β-mediated mechanisms.

中文翻译：

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女性生命中的围绝经期：导致后期神经退行性疾病的全身炎症阶段

围绝经期或绝经过渡期——女性生殖生命的最后几年——与女性身体的深刻生殖和荷尔蒙变化有关，并且会成倍增加女性患脑缺血和阿尔茨海默病的风险。尽管我们对围绝经期的确切时间线或定义的理解有限，但很明显围绝经期有两个阶段。这些是早期的更年期过渡，月经周期大多是规律的，中断相对较少；晚期过渡期，闭经变得更长，持续至少 60 天，直到最后一次月经期。新出现的证据表明，围绝经期会促炎并破坏受雌激素调节的神经系统。雌激素是一种主要调节剂，通过雌激素受体亚型 α (ER-α) 和β (ER-β) 网络起作用。雌激素受体-β 已被证明可以调节称为炎症小体的先天免疫反应的关键组成部分，并且它还参与神经元线粒体功能的调节。本综述将概述作为炎症事件的更年期过渡，以及相关的全身和中枢神经系统炎症，以及通过 ER-β 介导的机制对先天免疫反应的调节。