Hormone treatment may ease menopause 'brain fog,' study suggests

by University of California, Los Angeles

edited by Sadie Harley, reviewed by Robert Egan

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Many women going through menopause report struggling with memory lapses, trouble concentrating and slower thinking, a set of symptoms often described as "brain fog." A new study by UCLA Health suggests an estrogen hormone treatment combining estriol and progesterone may help ease these symptoms, offering an early but potentially promising way to address a menopause-related symptom for which there is currently no FDA-approved treatment.

The study, published in the journal Scientific Reports, was an observational case series that followed 20 menopausal women with an average age of 53. The women underwent a baseline assessment for cognitive symptoms before treatment and were then treated for 12 months with a customized regimen of estriol and progesterone.

How estriol may differ

Estriol is a natural form of estrogen that occurs during pregnancy and has been used in Europe and Asia to treat other menopausal symptoms, such as hot flashes and genitourinary symptoms. Estriol differs from estradiol, the most commonly used estrogen hormone therapy in the U.S., by binding primarily to a different estrogen receptor in the brain.

Previous research has shown that estriol may play a role in protecting brain cells and reducing brain atrophy in the hippocampus, which is responsible for learning and memory.

Reported gains after treatment

After the 12-month treatment regimen, the study participants reported significant reductions in brain fog and problems with concentration, working memory, processing speed, verbal memory and problem-solving compared with their symptoms before treatment.

"Estrogen plays a well-documented role in protecting the brain, yet there is still no approved treatment type or dose that specifically targets the cognitive symptoms so many women experience during menopause," said the study's senior author, Dr. Rhonda Voskuhl, a neurologist and member of the Comprehensive Menopause Center at UCLA Health.

"Women are often told to simply live with brain fog, when in fact there is a neuroscience basis for it, and potentially a way to address it. That gap in care is what motivated us to look more closely at estriol."

Mouse data point to mechanism

To better understand how the hormone treatment might work, the research team also studied estriol treatment in midlife female mice. Estriol reduced markers of brain pathology in the hippocampus, the brain region responsible for learning and memory, and improved the animals' cognitive performance, including working memory and spatial memory.

The study's authors caution that this was a small, preliminary case series without a placebo group or randomization, so the findings may not generalize to broader populations. Larger, placebo-controlled clinical trials that include brain imaging and standardized cognitive testing are now warranted to confirm the promising results on cognitive symptoms.

The hormone treatment used in the study was invented by Dr. Rhonda Voskuhl and is a patented product of UCLA. UCLA licenses the patent to CleopatraRX, which sells the treatment under the name PearlPAK. Voskuhl, an author of this study, serves as a medical advisor to CleopatraRX.

Publication details

Targeting hormone treatment for the brain in menopause, Scientific Reports (2026). DOI: 10.1038/s41598-026-65603-4

Journal information: Scientific Reports

Key medical concepts

Mental FatigueCognitive function

Clinical categories

NeurologyWomen's healthObstetrics & gynecologyHealthy aging Provided by University of California, Los Angeles Who's behind this story?

Sadie Harley

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