Your brain on menopause

Menopause is a natural biological process marking the end of a woman’s reproductive years, typically occurring in the late 40s to early 50s. While physical symptoms, such as hot flashes and hormonal changes, are widely recognized, the effects on the brain are equally significant and often overlooked.

By Olivia Eisner, Certified Nurse Midwife, Nuvance Health

Hormonal shifts and cognitive changes

The transition into menopause is accompanied by a decline in estrogen levels, a hormone that plays a crucial role in brain health. Estrogen supports memory, learning and overall cognitive function by promoting glucose metabolism in the brain. As estrogen levels drop, many women experience symptoms like forgetfulness, “brain fog” and difficulty concentrating. These changes are not merely anecdotal; research has shown menopause can alter brain structure, energy metabolism and neural connectivity.

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Memory and mood

The hippocampus, a brain region critical for memory and learning, is particularly affected during menopause. Studies have linked lower estrogen levels to changes in hippocampal connectivity and memory performance. Additionally, mood swings and emotional fluctuations are common, as estrogen also influences the amygdala, the brain’s emotional center.

Long-term implications

The neurological changes during menopause may have long-term implications for brain health. For instance, reduced estrogen levels have been associated with an increased risk of developing Alzheimer’s disease. However, it is not all bleak; some women maintain high cognitive performance post-menopause, suggesting individual differences and lifestyle factors play a role.

Strategies for brain health

Maintaining brain health during and after menopause involves a combination of lifestyle choices and medical interventions. Regular physical activity, a balanced diet rich in antioxidants and staying mentally sharp (through cognitive training activities and learning new skills and hobbies) can help mitigate cognitive decline.

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Hormone replacement therapy (HRT) may also have a place in slowing cognitive decline. Although it is not specifically approved for brain health, research indicates initiating HRT in perimenopause or early menopause may positively affect brain activity and memory function. Although further research is needed to determine the most effective timing, dosage, route of administration (oral vs. transdermal) and duration of therapy.

HRT is generally regarded as safe, and many of the concerns raised by the Women’s Health Initiative study in the early 2000s have been re-evaluated and clarified over time. It is crucial for individuals considering HRT to have a personalized discussion with their healthcare provider to weigh the potential benefits and risks based on their specific health needs and circumstances.

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In addition, metabolic health profoundly impacts brain function. Alzheimer’s disease is often referred to as “Type 3 diabetes” due to its links to insulin resistance and glucose metabolism in the brain. Maintaining an optimal hemoglobin A1c (hgba1c) level — an indicator of long-term blood sugar control — is crucial. For individuals who are diabetic or prediabetic, keeping glucose levels in a healthy range can help protect against cognitive decline and reduce the risk of conditions like Alzheimer’s.

Understanding how menopause affects the brain is essential for empowering women to navigate this life stage with confidence and resilience. By addressing both the physical and cognitive aspects of menopause, we can promote a more holistic approach to women’s health. Improving brain health during menopause involves nurturing the brain, body and overall well-being. Here are some effective strategies to consider:

Learn more about menopause at Nuvance Health.

1. Prioritize Physical Activity and Strength Training

• Regular exercise, both strength training and aerobic activities, improves blood flow to the brain and supports memory and cognitive health. Specifically, strength training can promote neuroplasticity — the brain’s ability to adapt and form new neural connections. This can enhance learning, memory and overall cognitive function. Yoga and tai chi can also reduce stress and enhance focus.

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2. Adopt a Brain-Healthy Diet

• A Mediterranean-style diet filled with antioxidant-rich foods such as fruits, vegetables, whole grains, lean proteins and healthy fats (like omega-3s) is shown to boost brain health. Foods like salmon, walnuts and blueberries are especially beneficial. Fermented foods such as yogurt, kefir, sauerkraut and kimchi also support gut health, increasingly recognized for its connection to brain health through the gut-brain axis.

3. Stay Mentally Active

• Engage in activities that challenge your brain, such as puzzles, reading, learning a new skill or picking up a hobby. Cognitive training games can also help sharpen memory.

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4. Manage Stress

• Chronic stress can interfere with memory. Techniques like meditation, deep breathing or mindfulness can help reduce stress and improve focus.

5. Get Quality Sleep

• Aim for 7-9 hours of restful sleep each night. Sleep is essential for memory consolidation and overall cognitive function. If you’re experiencing insomnia or hot flashes that disrupt sleep, consider consulting a healthcare provider.

6. Stay Socially Connected

• Building and maintaining strong social connections helps stimulate the brain and ward off feelings of isolation, which can negatively impact memory.

7. Consider Supplements or Hormone Therapy

• Some women find relief with hormone replacement therapy (HRT) or supplements like vitamin D and B-complex vitamins. Always discuss these options with a healthcare professional.

8. Stay Hydrated

• Dehydration can impair cognitive function, so make sure to drink plenty of water throughout the day.

Learn more about women’s health at Nuvance Health.

The bottom line: Implementing healthy lifestyle changes can make a significant difference in memory and cognitive function during menopause. If certain symptoms persist or worsen, consulting a doctor, nurse practitioner, certified nurse-midwife or neurologist can help identify personalized strategies.

Olivia Eisner is a Menopause Society Certified Practitioner (MSCP) and sees patients at the Norwalk Women’s Health and Wellness Center at iPark, part of Norwalk Hospital.

Learn more about and/or book an appointment with Olivia Eisner.