For years, women who experienced various concerns, such as insomnia and mood swings during midlife, were often dismissed by doctors on the grounds that they were imagining their symptoms. But new research confirms that these are real changes that the brain undergoes during menopause.
Studies of women before, during and after menopause show significant changes in brain structure, connectivity and energy metabolism. These changes are visible on scans and felt by many women, says neuroscientist Lisa Mosconi, author of "The Menopausal Brain."
"Menopause affects the brain. We're not crazy. We're not losing our minds," says Mosconi, an associate professor at Weill Cornell Medicine.
Mosconi's research reveals that gray matter volume decreases in areas responsible for attention, concentration, language, and memory.
Furthermore, the brain's ability to metabolize glucose declines, which may explain common symptoms of menopause.
Fortunately, these symptoms are often temporary. Most women find that their symptoms improve or disappear after menopause, explaining that "the brain is adjusting to its new biology."
These adaptations allow women to live a significant part of their lives after menopause.
The role of estrogen in the brain
Estrogen regulates behavior, cognitive function, and neuronal health. During menopause, estrogen levels drop significantly, affecting various regions of the brain:
- Hypothalamus: Regulates body temperature, leading to hot flashes.
- Hippocampus: important for learning and memory, affecting cognition.
- Amygdala: Influences emotional responses.
- Brainstem: Regulates sleep-wake cycles.
The evolution of the female brain
Women's brains change during puberty, pregnancy and menopause. Neurons once essential for menstruation and pregnancy are no longer needed, leading to a "rejuvenation," Mosconi says.
While it is unclear whether these changes can be prevented, stopped, or reversed, some appear to be temporary. Studies show that brain activity stabilizes and gray matter volume may recover after menopause. More research is needed to better understand these changes.
Managing menopause symptoms
A combination of a healthy lifestyle and pharmaceutical interventions can ease the transition to menopause. In addition to medications, a healthy diet, regular exercise, and good sleep can help with a smoother menopause.
