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Menopause and Brain Function

Medically reviewed by Susan Kerrigan, MD, Karyn Eilber, MD and Marianne Madsen on January 3, 2023

When a woman thinks about menopause, thoughts of hot flashes, mood swings, and the last period of her life may come to mind. But one symptom of menopause not commonly thought about is a change to the brain, which can result in temporary brain fog — the inability to recall a person’s name, wandering attention, and forgetfulness. The good news, though, is that these changes to a woman’s brain as she enters and goes through menopause are both normal and temporary.


Changes during menopause


One of the biggest changes a woman’s body undergoes during menopause is the stopping of the production of a hormone called estradiol, which is the form of estrogen that interacts most with the brain. Menopause often makes a person think about the ovaries and the hormones they produce. While the ovaries are where these hormones are produced, many symptoms of menopause are in fact brain symptoms. Neurologist Lisa Mosconi describes the changes in the brain that happen during menopause well in her TED Talk.


The estradiol hormone directly impacts changes in memory for women entering menopause, and the hormone leads to a reorganization of the brain’s circuitry that regulates memory function. As women enter menopause, the levels of glucose, which fuels the brain, decrease, so the brain looks for other sources of energy as it adapts to the change so it can maintain its normal functions


There are many changes happening to a woman’s brain during menopause, and some of those changes can cause memory issues and cognitive issues such as brain fog. However, the brain is a pretty remarkable organ, and it adapts to a new environment that is largely free of estradiol. That means that the memory symptoms a woman faces while going through menopause are temporary.  


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Menopause - Hormone Treatments

Menopause - Hormone Treatments

How do hot flashes relate to memory issues?


Hot flashes and night sweats can be common symptoms of menopause as hormones such as estradiol begin to diminish in a woman’s body. These types of symptoms are called vasomotor symptoms, and they can correlate with memory issues — often the more hot flashes a woman going through menopause experiences, the more cognitive impairment she may face. An issue that often emerges is cognitive decline, which includes forgetfulness and several verbal issues including delayed memory, reduced processing speed, and impaired learning. Again, this is typical as hormones change, and brains do adapt and return to previous function levels in most cases.


Does hormone replacement help brain function?


Hormone replacement therapy can be helpful in protecting brain activity and memory function, as long as it is administered at the correct time. Hormone replacement given during perimenopause, which is about four to eight years before menopause starts, can have positive effects. However, studies show that hormone replacement in late menopause may actually cause harm and increase the risk of disorders such as Alzheimer’s disease.


How can women maintain brain health?


While the memory and brain effects of menopause are typically temporary, it is still important to find ways to improve memory as women age. Three main pillars for memory maintenance are:


  • Physical Activity. It is important to engage in effortful physical activity, meaning that you are doing more than just your usual walking to get to places. There is no specific regimen to maintain brain health, but a mix of aerobic exercise, resistance training (which means lifting weights), and mind-body exercises, such as tai chi or yoga, several times per week can help.
  • Cognitive Activity. It is important to continue engaging your brain with mental challenges and activities that require you to apply logic and reasoning. These kinds of activities include reading the newspaper or books, writing letters, and playing games (particularly games with only one right answer, such as crosswords or sudoku puzzles).
  • Social Contact. It can be easy to become more isolated as we age. Children are grown and out of the house, you may have retired from work, and, especially during the pandemic, you may have less social contact with friends and loved ones than before. However, humans are social animals, and ensuring that we spend a good amount of time around other people is important for our brain health. Holding long conversations with others or playing games or doing other mentally engaging activities can continue to improve brain health and reduce memory issues.


Being active, physically, mentally, and socially, can help with your symptoms until your brain adjusts to the reduced estradiol — and beyond. These types of activities help keep your brain young and stave off cognitive decline no matter what period of life you’re in.

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