A major UK study shows menopause triggers brain changes resembling those in Alzheimer’s disease.
Researchers examined nearly 125,000 women, including MRI scans from 11,000, and found grey matter loss in memory and emotion centres. This may explain why dementia affects women nearly twice as often as men. Hormone replacement therapy failed to prevent the shrinkage.
Professor Barbara Sahakian, senior author from the University of Cambridge, said, “The brain regions where we saw these differences are ones that tend to be affected by Alzheimer’s disease. Menopause could make these women vulnerable further down the line. While not the whole story, it may help explain why we see almost twice as many cases of dementia in women than in men.”
Key areas hit include the hippocampus for learning, the entorhinal cortex for memory and navigation, and the anterior cingulate cortex for attention and mood control. Grey matter holds neuron bodies and local links, unlike white matter’s distant signal carriers.
Oestrogen decline boosts Alzheimer’s-linked proteins and worsens brain fog, sleep issues, and anxiety. Women make up two-thirds of UK Alzheimer’s cases.
NHS backs hormone replacement therapy for hot flushes and insomnia, but its brain impact is unclear. Therapy users often had prior mental health struggles.
Co-researcher Dr. Christelle Langley said it was important to recognise the variety of struggles that can come with menopause. “We all need to be more sensitive to not only the physical, but also the mental health of women during menopause. There should be no embarrassment in letting others know what you’re going through and asking for help.”
Michelle Dyson from the Alzheimer’s Society said women account for around two-thirds of people living with Alzheimer’s disease in the UK. “And while we still don’t fully understand why they are more susceptible than men, it is thought that hormones may play a role. This large study adds to evidence showing how menopause impacts the brain, including physical changes such as loss of brain volume. But without long-term participant tracking, to check if they later develop dementia, we cannot be sure that these brain changes associated with menopause also increase dementia risk.”
She said getting regular exercise, not smoking and limiting alcohol intake can help cut the risk of dementia.