a study reveals what happens in the brain

Menopause is a determining stage in women’s lives, marked by the cessation of menstruation as a consequence of the reduction in hormonal levels. It usually occurs between 45 and 55 years and may be accompanied by symptoms such as hot flashes, mood disturbances and sleep problems. Previous research had already linked this stage with cognitive difficulties, such as memory, attention and language failures.

To alleviate these effects – especially depressive symptoms and insomnia – many women receive hormone replacement therapy (HRT). In England, in 2023, around 15% of women used this treatment. However, until now there was limited knowledge about the real impact of menopause and HRT on the brain, cognition and mental health.

A new study of the Cambridge Universitypublished in the magazine Psychological Medicinereveals that menopause is associated with significant gray matter reductions in key regions of the brain, as well as at higher levels of anxiety, depression and sleep disorders. The research concludes that HRT does not seem to reverse these structural changes, although it could. slow worsening reaction times.

The scientific team analyzed data from the UK Biobank corresponding to about 125,000 womenclassified into three groups: premenopausal, postmenopausal without HRT, and postmenopausal who had received HRT. In addition to questionnaires about mental health, sleep and general well-being, some participants completed cognitive testsand some 11,000 they underwent MRIs to evaluate brain structure.

The mean age at onset of menopause was 49.5 yearswhile women treated with HRT began therapy around the 49 years. The results showed that postmenopausal women were more likely to have sought medical help for anxiety or depressionas well as receiving antidepressantscompared to premenopausal women.

Although women taking HRT had higher levels of anxiety and depression, the researchers note that these symptoms They already existed before menopausesuggesting that in some cases the therapy was prescribed preventively.

Regarding rest, postmenopausal women reported more insomnia, shorter sleep duration and greater fatiguethe latter being more pronounced in the group treated with HRT, despite not sleeping fewer hours than the others.

A “crucial” stage in a woman’s life

Dr. Christelle Langley, from the Cambridge Department of Psychiatry, emphasizes that menopause is a “crucial”regardless of whether HRT is used or not. Highlights the importance of maintaining a healthy lifestylewith regular exercise and a balanced diet, to mitigate some of its effects.

Experts insist on the need to pay attention not only to the physical healthbut also to the mental health of women during this stage, and they emphasize that asking for help should not be a reason for shame.

On a cognitive level, postmenopausal women without HRT showed slower reaction timeswhile no significant differences were observed in memory tests between the three groups. According to Dr. Katharina Zühlsdorff, menopause could accelerate cognitive agingalthough HRT seems to slow it down slightly.

Significant gray matter reductions

MRIs revealed a decrease in gray matter volume in areas such as the hippocampusthe entorhinal cortex and the anterior cingulate cortexkey regions for memory, emotions and decision making.

Professor Barbara Sahakian, lead author of the study, warns that these areas are also the ones affected by the Alzheimer’s diseasewhich could help explain why the Dementia is almost twice as common in women as in men.

The research was funded by the Wellcome Trust, with additional support from the National Institute for Health and Care Research (NIHR) at Cambridge Biomedical Research Centre.