How menopause changes the brain and steps to protect it
Across the U.S., roughly 6 million adults 65 and older have Alzheimer’s disease. Almost twothirds of them are women — a discrepancy that researchers have long attributed to genetics and women’s longer life spans, among other reasons. But there is growing consensus that menopause may also be an important risk factor for the development of dementia later in life.
Women going through the life phase, which is clinically defined as the end of fertility, face as many changes in the brain as in the ovaries, said Dr. Lisa Mosconi, a neuroscientist and director of the Women’s Brain Initiative at Weill Cornell Medicine. While the vast majority of women will weather these changes without long-term health consequences, about 20% will develop dementia in the decades that follow.
The female brain is rich in estrogen receptors, particularly in regions that control memory, mood, sleep and body temperature, all of which “work beautifully when estrogen is high and consistent,” Mosconi said. Estrogen is also vital for the brain’s ability to defend itself against aging and damage.
The characteristic decline in estrogen during menopause not only alters the functioning in some brain regions, she said, it is also thought to change the brain’s structure; scans show reduced volume in menopausal brains compared to male brains of the same age and to those of pre-menopausal women.
These neurological changes may be responsible for some menopausal symptoms, including hot flashes, mood disruption and a mild, usually temporary decline in memory and cognition.
They also resemble changes in the brain that precede dementia, Mosconi said. “Some of the brain regions that are impacted by menopause are also some of the regions impacted by Alzheimer’s disease,” she said, but the link between the two is not fully understood.
The symptoms of menopause themselves, such as lack of sleep and hot flashes, have been linked to dementia too. A study published in 2022 found that hot flashes were associated with an increased amount of tiny lesions in the brain, which are a sign of declining brain health, said Dr. Pauline Maki, a professor of