WASHINGTON, Oct 26 – The menopause transition can be a challenging phase in life. While hot flashes are common, hormonal changes during this period may also cause deeper effects on the brain, influencing memory, mood, and daily function.
Researchers from the BRAVE Lab at Ponce Health Sciences University have reviewed recent studies to identify how menopause alters brain structure. Their findings will be presented at the 2025 Annual Meeting of The Menopause Society.
Brain changes linked to menopause
The research team reviewed peer-reviewed studies from the past five years to explore connections between menopause and the brain. They found a consistent pattern showing a drop in gray matter volume during the menopause transition.
Gray matter is critical for memory, decision-making, and day-to-day functioning. Its reduction is linked to cognitive decline. However, some studies suggest partial recovery of gray matter volume after menopause, indicating that the brain may adapt and reorganize itself over time.
The researchers also found changes in white matter, particularly white matter hyperintensities – bright spots on MRI scans that may reflect stress or damage to brain communication pathways. These spots were more pronounced in women who experienced early menopause or frequent vasomotor symptoms such as hot flashes and night sweats.
Overall, the findings suggest menopause may cause measurable brain structure changes that could influence thinking, memory, and emotional well-being.
Experts urge caution and context
Dr. Stephanie Faubion, medical director for The Menopause Society, told Medical News Today that women should not be overly alarmed by these findings.
“While menopause is related to some structural brain changes, we don’t have a clear understanding of whether these changes lead to cognitive decline,” she said.
She added that forgetfulness or difficulty concentrating during menopause does not necessarily indicate a serious problem. “There is no evidence that symptoms of brain fog during menopause are linked to dementia later in life, which is reassuring,” Faubion noted.
Role of hormone therapy and brain protection
Dr. Rhonda R. Voskuhl, professor of neurology at UCLA and inventor of CleopatraRX, emphasized the importance of hormone replacement therapy (HRT). “Early treatment with estrogen is better than later treatment,” she said. “Women become less responsive to estrogen over the years.”
Voskuhl added that women with a uterus also need progesterone as part of their therapy. She explained that the loss of neuroprotective estrogen might contribute to higher Alzheimer’s risk in women 10 to 20 years after menopause. More research is needed to confirm whether HRT can reduce this risk.
Understanding menopause and its symptoms
Menopause occurs when a person has not had a menstrual period for 12 consecutive months, signaling that the ovaries have stopped producing estrogen and progesterone. The period leading up to it is called perimenopause, which can last several years.
Common symptoms include:
• hot flashes
• night sweats
• mood swings
• fatigue and low energy
• irregular or missed periods
• cognitive difficulties such as memory lapses or brain fog
These symptoms vary in intensity and duration. Doctors often prescribe hormone therapy or antidepressants like SSRIs (Lexapro, Prozac, or Zoloft) to manage symptoms such as mood changes, sleep problems, and hot flashes.
Not everyone is a candidate for hormone therapy, and treatment decisions should be discussed with a healthcare professional.
This report was originally published by Medical News Today.