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A growing body of research is shedding light on how menopause doesn’t just affect hormones—it also reshapes the brain itself. Scientists have linked this transition to visible structural changes that can influence memory, focus, and emotional well-being. The good news: these changes may not be permanent, as evidence points to the brain’s ability to recover and adapt over time.
How Menopause Affects the Brain
Many women describe experiencing “brain fog” during menopause — a feeling of forgetfulness, reduced concentration, and mental sluggishness. Experts believe these symptoms are partly due to hormonal fluctuations that occur during this stage of life. To better understand the biological connection, researchers reviewed studies examining how menopause impacts brain structure and function. The results of this review will be shared at the 2025 Annual Meeting of The Menopause Society in Orlando.
Structural Changes in the Brain
Studies show that menopause can lead to noticeable changes in brain tissue. Researchers have observed decreases in gray matter — the part of the brain responsible for memory, learning, and decision-making — particularly in the frontal, temporal, and hippocampal regions. These declines have been linked to weaker performance in memory-related tasks such as word recall and spatial awareness.
Additionally, white matter — which helps transmit information between brain regions — may also be affected. Some women, especially those who experience early menopause or frequent hot flashes, show small white matter lesions on brain scans. These bright spots, called white matter hyperintensities, are signs of reduced blood flow and may increase the risk of cognitive decline, mood changes, balance issues, and even stroke or dementia later in life.
Signs of Recovery and Brain Adaptation
Despite these challenges, scientists have found encouraging evidence that the brain may regain some of its structure after menopause. Gray matter volume, for instance, appears to partially recover, suggesting that the brain compensates through a process known as neuroplasticity.
Researchers have also discovered a rise in estrogen receptor density during the menopausal transition, indicating that the brain might be adjusting to lower hormone levels. However, this adaptation can have mixed effects—while it shows resilience, it’s also been linked to certain memory difficulties. Other studies reveal changes in blood vessel function and brain energy use, reinforcing how deeply menopause influences neural health.
The Research Behind the Findings
At the BRAVE Lab within the School of Behavioral and Brain Sciences at Ponce Health Sciences University in Puerto Rico, PhD psychology students Angélica Rodríguez and Andrea Pereira led a comprehensive review of scientific literature on this topic. Under the guidance of Dr. Bárbara Barros and Dr. Karla Martínez, they examined how structural brain changes may contribute to the emotional, cognitive, and physical symptoms of menopause.
“This type of work highlights the need to continue exploring the relationship between the brain and menopause, particularly their connection with the cognitive, emotional, and behavioral symptoms women experience during this stage,” said Rodríguez.
Their findings will be presented at the upcoming 2025 Menopause Society conference in a poster session titled “Menopause and Brain Structural Changes: A Bibliographic Revision.”
Moving Toward Better Understanding and Care
Dr. Stephanie Faubion, Medical Director of The Menopause Society, emphasized the importance of these findings. “This study represents the cumulative body of scientific knowledge relative to structural changes that take place in the brain during menopause,” she explained. “These data will hopefully lead to a better understanding of the factors underlying some of the cognitive concerns experienced by women during the menopause transition so that we can ultimately identify effective therapies.”
Summary
The findings highlight that menopause is more than just a hormonal milestone — it’s a neurological transformation. While brain fog and cognitive changes are common, research suggests that the brain’s ability to recover and adapt may help women regain clarity and cognitive balance over time.
