Menopause-linked brain changes may differ from those in puberty and pregnancy
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Changes in the female brain during menopause contrast sharply with those seen during pregnancy and puberty, according to brain imaging research published in Nature Communications. The study, which included more than 200 participants, suggests that puberty and pregnancy are both associated with reductions in cortical gray matter volume, while menopause is characterized by relatively stable gray matter volume during the transition itself.
Puberty, pregnancy and menopause are major hormonal transitions experienced across the female lifespan that have profound effects on the brain. However, it is unknown whether changes during these three stages involve shared or distinct mechanisms. Additionally, although previous studies have examined brain changes during puberty and pregnancy, there has been less research into changes associated with menopause.
Tracking three hormonal transitions
Sophie van 't Hof and colleagues analyzed structural MRI data collected at multiple intervals during transitions through puberty (34 participants), pregnancy (70 participants) and menopause (120 participants), alongside control groups of individuals at similar ages who were pre- or post-transition. The control groups included 108, 40 and 723 individuals, respectively.
Transitions through the first menstrual period during puberty and through pregnancy were associated with accelerated monthly reductions in total and cortical gray matter compared with controls. Losses were observed in similar regions for both groups, including the prefrontal, parietal and temporal association cortices, while other regions diverged.
Menopause follows a different pattern
In contrast, the transition through menopause showed no notable total or cortical gray matter reduction compared with premenopausal and postmenopausal control groups. The authors infer that the absence of an age-related decline during the menopausal transition could be related to previously observed decreases in sex steroid hormones; however, further research would be needed to establish a causal link.
The findings indicate that puberty, pregnancy and menopause are associated with different patterns of brain structural change, rather than a single, uniform response to hormonal change.
Limits on the conclusions
The authors note several limitations, such as the self-reported nature of menopausal status and lack of directly measured hormonal data across all cohorts. Further study with standardized and comparable hormonal and imaging data will be needed to clarify the biological mechanisms behind these patterns.
Publication details
Sophie R. van 't Hof et al, Puberty, pregnancy, and menopause show shared and distinct structural changes across the lifespan, Nature Communications (2026). DOI: 10.1038/s41467-026-76755-2
Journal information: Nature Communications
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