When you think of perimenopause and menopause, you probably think about symptoms like hot flashes and weight gain. While you may think these are issues with the skin or body, they’re actually related to glitches in the brain. In fact, many menopause symptoms are associated with changes in the brain.
The hormonal upheaval that occurs during this time of a woman’s life impacts the menopause brain in ways that lead to issues with mood,
brain fog, anxiety, memory, sleep, and the regulation of body temperature.
Here’s how
menopause impacts the brain, sets you up for symptoms, and what you can do about it.
WHAT ARE NEUROHORMONES?
Hormones are chemical messengers produced in the body that control and regulate the
When neurohormones are balanced, you tend to feel energetic, positive, and mentally sharp. When hormone levels are imbalanced you’re more likely to experience brain health problems and mental health issues, such as clinical
depression,
anxiety disorders,
panic attacks, Alzheimer’s disease, and other types of dementia.
ESTROGEN IN THE BRAIN
The female brain has many estrogen receptors, especially in areas involved in moods, memory, body temperature, and sleep.
The female body produces three kinds of estrogen:
- Estrone (E1), the primary estrogen produced following menopause, plays a role in breast and uterine cancer.
- Estradiol (E2), the strongest estrogen, promotes healthy cognitive function and positive moods. Overproduction of estradiol has been associated with estrogen-related cancers, while underproduction contributes to dementia, heart disease, osteoporosis, and other diseases of aging.
- Estriol (E3), which protects breast and vaginal tissue, the urinary tract, and bone density, also helps to reduce hot flashes in women.
When estrogen levels are healthy and balanced, it helps optimize brain function, which contributes to positive moods, a sharp memory, comfortable body temperature, and restful sleep.
Research shows that estrogen also plays a critical neuroprotective role, preventing brain aging.
After menopause, women produce dramatically lower levels of E2 and E3. This means women lose their neuroprotective effects.
The drops in estrogen levels that occur during menopause cause changes in the brain that can lead to mood problems,
memory loss, and more.
PROGESTERONE IN THE BRAIN
Another primary hormone produced in the female body is progesterone. There is a high concentration of progesterone receptors in the brain.
Think of progesterone as the “relaxation hormone.” When it is in balance with estrogen, it calms you, brings feelings of peacefulness, and promotes sleep. It has also been shown to reduce inflammation and counteract damage from brain injuries.
Neuroscience
research shows that progesterone affects the brain in the following ways:
- Supports gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter that helps the brain relax
- Protects your nerves
- Supports the myelin that “insulates” and protects neurons
During perimenopause and after menopause, levels of progesterone drop. This can lead to irritability, anxiousness, depression, sleepless nights, and brain fog.
5 WAYS MENOPAUSE IMPACTS BRAIN FUNCTION
- Changes in brain structure
A 2021 brain-imaging
study in
Scientific Reports found that the menopause transition is associated with several changes in the brain, including reductions in gray matter volume, connectivity, and energy metabolism.
Other neuroimaging
research also found decreases in brain volume in postmenopausal women compared to pre-menopausal women and males of the same age.
- Drops in neurohormone levels
In postmenopausal women, estrogen and progesterone levels plummet. This may result in:
- Anxiety
- Depression
- Hot flashes
- Night sweats
- Mood swings
- Crying spells
- Memory problems
- Increased sensitivity to pain
This transition can be so challenging that it prompts women to start taking mental health medications for the first time.
- Decreased blood flow to the brain
When estrogen declines, so does blood flow to the brain. At Amen Clinics, functional brain scans using single photon emission computed tomography (
SPECT) show that low blood flow is associated with depression, anxiety disorders, insomnia, weight gain, problems with concentration, memory loss, and brain fog.
- Tiny brain lesions
Findings in a 2022 brain-imaging
study in
Neurology found that hot flashes, especially night sweats, increased white matter hyperintensity volume. In simple terms, these are tiny brain lesions in the white matter.
Research shows that these lesions are associated with increased risk of cognitive decline, stroke, and other conditions.
- Biomarkers for Alzheimer’s disease
A 2024
study points to an association between nighttime hot flashes and increases in Alzheimer’s disease biomarkers.
TREATMENT FOR MENOPAUSE-RELATED BRAIN CHANGES
Although these menopause-related brain changes may seem alarming, they aren’t necessarily permanent. Much of the research suggests that the brain changes and cognitive function issues noted during the menopause transition resolve over time.
If you’re struggling with menopause symptoms, it’s important to seek treatment and adopt a brain-healthy lifestyle.
- Bioidentical hormone replacement therapy (BHRT)
Hormone replacement therapy continues to be controversial. It can be highly effective for the treatment of menopause symptoms like
hot flashes/night sweats, weight gain, mood swings, memory loss, vaginal dryness, sleep problems, and libido.
However, early research found that use of a synthetic estrogen increased the risk for breast cancer, heart disease, stroke, and blood clots.
The medical community has since shifted to treating women with bioidentical HRT, which is identical to the hormones produced in the body.
These bioidentical hormones also came under fire for potentially contributing to Alzheimer’s disease and other types of dementia in older women. New research puts an end to these fears.
A 2023
meta-analysis of more than 50 studies has found that using bioidentical HRT at the time symptoms begin is associated with reduced risk of Alzheimer’s disease and other dementias.
- Exercise
Engaging in physical activity on a regular basis can help you through the menopause transition and postmenopause. One
study found that high levels of exercise help reduce menopause symptoms.
Be sure to include strength training as part of your exercise routine. It can help offset the loss of muscle mass and bone density that typically occurs as women age.
Even if you’re tired, get your daily dose of exercise anyway. It provides natural energy, revs “happy” endorphins for your mood, and can help preserve and increase brain function.
- Stress reduction
Daily stress exacerbates brain fog and moodiness, so it’s important to develop a stress-reduction practice. Mindfulness-based stress reduction (MBSR) may help reduce menopause symptoms, according to
research.
MBSR is a program that involves activities like yoga, meditation (sitting or walking), and an awareness technique called the body scan. This technique involves scanning your body and becoming aware of feeling and sensations in a nonjudgmental way.
For some women,
cognitive behavioral therapy (CBT) can be an effective way to learn skills and strategies for coping with stress. CBT is also useful as a depression treatment, a way to deal with hot flashes, and other menopause symptoms.
- Sleep hygiene
If you have trouble sleeping, develop a healthy sleep routine. Avoid caffeine later in the day, skip the alcohol with dinner, keep your bedroom cool, and turn off your tech devices at least an hour before bedtime.
- Healthy brain foods
Fuel your brain and body with nutrient-dense whole foods that provide you with more natural energy and mental sharpness, but fewer cravings. To minimize menopause symptoms, avoid alcohol, caffeine, high-sodium foods, sugar-laden foods and beverages, and ultraprocessed foods.
With a holistic approach to menopause, you can not only survive but also thrive while aging. If menopause symptoms don’t respond to the treatments listed here, consider seeing a medical or mental health professional for more personalized care.
Anxiety, depression, memory loss, brain fog, and other mental health issues related to menopause can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.
