A study analyzing data from nearly 125,000 women from the UK Biobank found that menopause is associated with poorer sleep, increased mental health problems, and significant changes within the brain itself. Post-menopausal women were more likely than pre-menopausal women to report symptoms of anxiety and depression and were also more likely to seek help from a general practitioner or psychiatrist and to be prescribed antidepressants.
Sleep disturbances emerged as another significant effect of menopause. Post-menopausal women reported higher rates of insomnia, shorter sleep duration, and increased fatigue compared to pre-menopausal women. Brain imaging analyses revealed significant reductions in grey matter volume following menopause, with reductions most pronounced in regions critical for learning and memory (the hippocampus and entorhinal cortex) and areas key in emotional regulation and attention (the anterior cingulate cortex). Notably, the hippocampus and entorhinal cortex are among the earliest affected in Alzheimer’s disease, suggesting that menopause-related brain changes may contribute to increased vulnerability to Alzheimer’s disease later in life.
Many women turn to hormone replacement therapy (HRT) to mitigate menopause effects including hot flashes, depressive symptoms and sleep problems. The study investigated whether HRT had beneficial effects on health outcomes. Notably, HRT did not improve the reduction in brain grey matter, and women using HRT showed higher levels of anxiety and depression compared to post-menopausal women who had never used HRT. However, further analyses indicated these differences were pre-existing, suggesting that pre-existing mental health problems may have influenced the decision to begin using HRT rather than the medication causing these symptoms.
One potential benefit of HRT was noted in cognitive performance, particularly for psychomotor speed. Post-menopausal women who had never used HRT showed slower reaction times compared with both pre-menopausal women and post-menopausal women who had used HRT. Evidence suggests healthy lifestyle habits may mitigate menopause-related changes in brain health, including regular exercise, cognitively challenging activities, a nutritious diet, quality sleep, and strong social connections.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.livescience.com/health/reproductive-health/how-menopause-affects-the-brain-and-what-we-still-dont-know