- Researchers at the University of Cambridge in the United Kingdom studied how menopause affects the brain.
- The study included both women who used hormone replacement therapy (HRT) to treat menopause symptoms and those who did not.
- Menopause was linked to lower gray matter volume in brain regions associated with Alzheimer’s disease.
- While the HRT group had slightly improved reaction time, HRT did not appear to reverse menopause-related brain changes overall.
Menopause occurs when the ovaries stop producing eggs, and individuals can no longer become pregnant. This transition is often linked to symptoms such as hot flashes and night sweats but scientists are learning that menopause may impact more than reproductive health.
Growing
The researchers in the current study wanted to explore this further, including whether HRT can mitigate these effects.
The study findings appear in Psychological Medicine.
Menopause typically
Depending on the severity of their symptoms, some individuals may need HRT, which can include estrogen-only or combined estrogen-progestin options.
Since newer research shows that menopause may also have a neurological impact, the researchers who conducted the recent study wanted to take a closer look at changes in women before and after menopause, including in those who took HRT.
The scientists analyzed data from almost 125,000 women registered with the UK Biobank. The researchers divided them into three groups:
- pre-menopause
- postmenopause with no HRT use
- postmenopause with HRT use.
Next, they analyzed the responses the women gave on questionnaires that targeted sleep, mood, anxiety, and lifestyle factors. The women also completed cognitive assessments that checked their memory and processing speed.
Finally, the researchers analyzed MRI scans from a subset of women to assess the gray matter volume of brain areas
The overall findings of how menopause impacts the brain were not promising.
In both the postmenopause and postmenopause with HRT groups, the participants saw consistent drops in cognitive tests compared to the pre-menopause group.
Both groups showed declines in memory and thinking speed, along with slower reaction times. However, the drop in reaction time was less pronounced among women using HRT.
When the scientists began comparing anxiety and depression between the groups, they saw that women who took HRT were more likely to experience both.
However, when they checked this group’s history, they realized these women were more likely to have been diagnosed with anxiety and depression before menopause and concluded that HRT was likely not the culprit.
Postmenopausal women also experienced worse sleep compared to pre-menopausal women. While both postmenopausal groups had higher rates of insomnia and fatigue compared to the pre-menopausal group, the women who took HRT reported the highest levels of fatigue.
The brain scan findings showed that both groups of postmenopausal women had smaller gray matter volumes in multiple brain regions compared with pre-menopausal women.
This included the hippocampus and entorhinal cortex, and both of these regions are important for memory. They also noted lower gray matter volume in the anterior cingulate cortex, a region important for emotional regulation and cognition.
The researchers pointed out that these specific brain areas are impacted in people who develop Alzheimer’s, and speculated that menopause could factor into why women have higher rates of dementia compared with men.
Even though both groups of postmenopausal women had reductions of gray matter volume, it was more pronounced in those who had used HRT.
Overall, the findings in this study showed that menopause may have serious neurological impacts that can affect women in the long run. Additionally, HRT has little to no effect on mitigating these effects — aside from reaction times.
While the study findings are bleak, experts who spoke with Medical News Today highlighted some ways women can take control of their Health and reduce some of these impacts.
Sherry Ross, MD, a board-certified OB/GYN and Women’s Health Expert at Providence Saint John’s Health Center, who was not involved in this research, emphasized how important lifestyle habits are for brain health.
There is an appropriate saying, “genetics loads the gun, and lifestyle pulls the trigger,” Ross shared. “This analogy highlights how genetic predispositions to certain medical conditions may be your destiny, but healthy lifestyle changes can minimize the effects of aging on brain health.”
Ross pointed out that modifiable factors such as smoking, poor diet, lack of exercise, and inadequate sleep are all linked to cognitive decline, as well as conditions such as heart disease and some cancers.
“Controlling positive lifestyle habits is an easy way to support brain health and a better quality of life,” she told us.
Tommy Wood, PhD, a neuroscientist and Associate Professor of Pediatrics and Neuroscience at the University of Washington, likewise not involved in this study, also spoke with MNT about the implications of its finidngs.
Wood emphasized that the results should not alarm women. He said about one in five women are expected to develop Alzheimer’s, and many cases may be preventable through healthy lifestyle choices.
“Even if menopause does lead to some gray matter loss, it won’t automatically lead to future cognitive decline or dementia,” Wood pointed out.
He also discussed some strategies women can use to preserve brain health as they age, advising that:
“Regular aerobic exercise — [such as] brisk walking, jogging, cycling, rowing etc. — has been shown to increase the size of the hippocampus in older adults at a time when it would otherwise be expected to decrease in volume.”
Finally, Wood shared that strength training can improve brain structure and cognitive function in postmenopausal women.
