Why do scientists still not understand how menopause changes the brain?

New research suggests that menopause affects the brain in ways that differ from other major hormonal transitions; the BMJ looked into this

Menopause is a natural stage of life, but scientists are still working to understand how it affects the brain. New research comparing brain changes during puberty, pregnancy, and menopause offers new insight into how the brain responds to major hormonal shifts.

The study, conducted by researchers in the Netherlands and published in Nature Communications, examined MRI brain scans from 1,095 participants. The findings suggest the brain may respond differently to menopause than to other hormonal transitions.

What the research found

Researchers compared changes in brain structure across three life stages: puberty, pregnancy, and menopause. They also examined control groups to help identify which changes were associated with each transition.

During puberty, beginning with the first menstrual period, and during pregnancy, participants showed accelerated monthly reductions in total grey matter and cortical grey matter. These changes were observed in brain areas involved in higher-level functions, including the prefrontal, parietal, and temporal association cortices.

Grey matter contains many of the brain cells and connections involved in processing information, memory, attention and decision-making. However, changes in grey matter do not automatically indicate that the brain is becoming less effective. They may reflect changes in how the brain develops, adapts and organises itself.

Why is menopuase different

The research highlights the possibility that menopause follows a different pattern of brain change from puberty and pregnancy. These differences may be linked to the distinct hormonal changes that occur during each stage of life.

However, understanding the physical changes seen on MRI scans is only part of the picture. Researchers still need to establish what these changes mean for everyday brain function, including memory, concentration, mood and other cognitive abilities.

Menopause can coincide with experiences such as brain fog, forgetfulness and difficulty concentrating. Although these symptoms are commonly reported, the relationship between hormonal changes, brain structure and cognitive function remains complex.

Brain scans alone cannot explain why some women experience these symptoms while others do not. Further research is needed to understand how individual differences, hormonal changes and other factors may influence the brain during menopause.

The findings are a step towards improving scientific understanding of women’s brain health. By examining menopause alongside other hormonal transitions, researchers can begin to identify what makes this stage unique.