- A research team from Puerto Rico carried out a literature review to compile findings on how menopause may reshape the brain.
- They reviewed studies published from 2020 to 2025 to get a better understanding of neuroanatomical changes during menopause.
- The researchers identified consistent patterns that may help explain the changes in thinking, mood, and overall Health that often occur during the menopause transition.
The menopause transition can be a difficult part of a person’s life. Hot flashes are a common symptom, but the effects of hormonal changes can run much more deeply and affect everyday life.
The research team of the new literature review, affiliated with BRAVE Lab at Ponce Health Sciences University, noted patterns in brain changes caused by hormones that may help explain many menopause-related symptoms.
The team will present their findings at the 2025 Annual Meeting of The Menopause Society.
Considering the impact menopause transition can have, especially throughout a decade or more of a woman’s life, the researchers of the new review wanted to review existing studies to see what links they could find between menopause and brain structure changes.
To do this, they searched various databases for studies published within the past five years related to menopausal symptoms and brain structure. They focused on the most recent research and only included peer-reviewed studies in their review.
After going through the studies, the researchers compiled the links they found between menopause and brain structure.
One pattern the review noted was that gray matter volume in the brain decreased.
Gray matter is
While this may sound concerning, the researchers said some studies suggest that gray matter volume may partially recover in postmenopause. This indicates that the brain may adapt and reorganize itself over time.
The research team also noticed a pattern in findings related to menopause and white matter hyperintensities.
White matter hyperintensities show up as bright areas on MRI scans and may reflect stress or damage to the brain’s communication pathways.
These spots can affect everyday thinking, memory, and mood, and may signal an increased vulnerability to certain neurological conditions over time. The hyperintensities were more pronounced in women who went through early menopause and who had frequent vasomotor symptoms (also known as hot flashes and include night sweats).
Overall, the findings suggest menopause may lead to measurable changes in brain structure, which may impact memory, thinking, and mood.
Stephanie Faubion, MD, medical director for the Menopause Society, spoke with Medical News Today about the review. She cautioned against becoming overly concerned about some of the links found between menopause and gray matter volume loss.
“While we know that menopause is related to some structural brain changes, we don’t have a clear understanding of whether these structural changes cause functional changes or cognitive decline,” said Faubion.
Faubion added that women who experience forgetfulness or trouble concentrating during the menopause transition should not assume it signals something more serious.
“Indeed, there is no evidence that symptoms of ‘brain fog’ during the menopause transition are associated with later risk of dementia, which is reassuring,” Faubion pointed out.
Rhonda R. Voskuhl, MD, Professor of Neurology at UCLA and Inventor of CleopatraRX, also spoke with MNT about the review and discussed the importance of hormone replacement therapy (HRT) during menopause.
“Early treatment with estrogen for menopause is better than later treatment,” said Voskuhl. “Women are thought to become less responsive to estrogen treatment over the years.”
It’s important to note that people who still have a uterus will also need progesterone.
Voskuhl also touched on long-term cognitive concerns for women who experience brain fog during menopause. She pointed out that “not all menopausal women get Alzheimer’s disease,” but it does affect women disproportionately.
“Loss of neuroprotective estrogen during menopause may contribute to susceptibility to getting Alzheimer’s disease 10 to 20 years later,” commented Voskuhl. She said that this would have to be further studied, including treating menopausal women with HRT to determine whether a “cause and effect relationship” exists.
The time leading up to menopause is called perimenopause, or the menopause transition, which can last for a decade or more. The average age of menopause is 51 to 52.
However, some people may reach menopause earlier, and those who undergo treatment for certain cancers or have their ovaries removed will reach medical menopause without going through perimenopause.
During this time, people experience physical and emotional changes resulting from shifting hormone levels. The symptoms of menopause can vary in intensity from mild to more disruptive.
Common symptoms include:
- hot flashes
- night sweats
- irregular or missed periods (before they stop completely)
- mood swings
- fatigue and low energy
Another symptom that people report is brain fog or
There are some ways to
They can also prescribe selective serotonin reuptake inhibitors (SSRIs), an antidepressant class that includes drugs such as escitalopram (Lexapro), fluoxetine (Prozac), or sertraline (Zoloft), for mood symptoms and hot flashes.
However, not everyone is a candidate for hormone therapy during menopause. Each individual can discuss their options with a doctor.
