Menopause and Brain Changes

Menopause is a natural part of aging for women. More than a million U.S. women go through it each year, according to the National Institute on Aging.

Menopause is determined to be after a woman hasn’t had a period for 12 months in a row. She can experience the symptoms of it for years beforehand and this phase is called  perimenopause. After menopause we use the term postmenopause.

For many women, peri-menopause and menopause can cause a lot of seemingly out-of-the-blue changes to women’s brains and bodies.Changes may include frustrating symptoms like hot flashes and weight gain, as well as brain-related issues with alertness and memory. These symptoms can often catch women off guard – especially if they’ve never had a discussion with other women on what to expect.

When you know what to expect, you may feel better prepared when symptoms start popping up and you recognize the root cause. The good news is that there are steps you can take to both offset these changes and/or lessen the symptoms.

Often, we discuss the weight gain and change in our bodies, but in this blog I’d like to discuss what’s going on in the brain during menopause, what might happen, and what you and your doctor can do about it.

Why women may experience brain changes during menopause

There are two main hormones, estrogen and progesterone, that can affect a woman’s reproductive health. They’re responsible for sexual development, ovulation, and for preparing the body to carry a child. When a woman goes into menopause, the body produces less of these hormones

Dipping or erratic levels of estrogen and progesterone can cause issues throughout many of the body’s systems. That includes the central nervous system, which contains the brain.

These hormones work together to protect nerve cells from damage, says Romie Mushtaq, M.D., a neurologist and integrative medicine specialist in Orlando, Florida, and author of The Busy Brain Cure. “Estrogen and progesterone interact with a variety of receptors in the brain that regulate aspects of brain function,” she says. “These include the generation of new brain cells, or neurons, and how these brain cells connect to one another.” Having less of these hormones can affect cognitive function.

Some women may experience brain fog. “Estrogen promotes brain cells to burn more glucose, which is the brain’s main fuel source,” says Dr. Mushtaq. When you have less estrogen, glucose (blood sugar) levels rise, which can cause issues with brain function. “Studies have shown there’s an overall reduction of brain energy levels during menopause, which contributes to brain fog and other mood symptoms,” notes Dr. Mushtaq. Brain fog can cause trouble with concentration, focus, and memory. This may be attributed to insulin resistance in the brain in some women. The energy isn’t getting into the cell.

Alzheimer’s risk may increase. It’s important to know that not all women will experience a buildup of harmful “plaques” in their brains during menopause—or develop Alzheimer’s disease. (After all, scientific studies generally report averages, not individual results.) But as Dr. Mushtaq notes, the dip in estrogen that occurs during menopause can increase the development of plaques in the brain, which are seen in Alzheimer’s disease.The increase in insulin resistance may be part of the picture as well. This is why reducing the amount of glucose may be helpful and increasing healthy fats.

Sleep may be more difficult. Menopausal and postmenopausal women are more likely to suffer from than men. In fact, postmenopausal women have a 35% to 60% higher risk of having a sleep disorder. Too little sleep can affect brain function. “Sleep deprivation promotes inflammation in the brain and will lead to elevated stress hormone levels, causing brain fog,” says Dr. Mushtaq. It can also make you less alert and have difficulty regulating emotions and making decisions. Part of this is the need for a cooler room. This is where thermostat wars may begin. Women and their brains need a cooler room between 66-69 degrees fahrenheit. Actually, all of us sleep better with the room cooler but sometimes our partners need to be convinced!

The risk for mental health issues might be higher. Research shows that menopausal and postmenopausal women have a higher chance of experiencing depression or anxiety. These changes can decrease two substances in the brain that help stabilize mood, according to a study in Australasian Psychiatry. These are the chemical serotonin, and gamma-aminobutyric acid (GABA), a naturally occurring amino acid. A drop in serotonin can lead to mood disorders like depression. And lower levels of GABA can make it harder for the body to relax after experiencing something stressful. There are some interesting studies showing the use of some adaptogens, such as Ashwagandha or Rhodiola Rosea can be helpful in reducing anxiety and help restfulness at bedtime.

You Can Help Manage Your Symptoms

Most studies are based on averages–and that means that some women will experience these issues much less than others, or even not at all. And all women can take steps to lessen these impacts. Here are some of the things you can do:

• Eat Brain Healthy Foods According to Harvard Medical School, eating a diet that includes foods like lean protein, fruits and vegetables, nuts and beans, and whole grains may help improve thinking, memory, and brain health. So, try adding more veggie sides to your weekly menu or incorporating more brain healthy foods like eggs, avocado and walnuts onto your plate. Reduce foods that cause a glucose spike such as breads, pasta, rice – or eat in moderation and whole grain versions.
• Improve Sleep Hygiene Sleep clears away toxins in the brain and help your body heal. If you’ve tried all the hacks for getting a better night’s sleep (like going to sleep at the same time each night, staying away from your phone, and keeping your bedroom cool), it might be a good idea to talk to your doctor. They might be able to recommend a sleep study, or provide other options for you. Stay clear of taking large doses of melatonin. If you take it discuss a pharmaceutical version from your doctor.
• Practice Mindfulness. Meditation, Tai Chi and Qigong can help ease mood issues, specifically anxiety and depression, which can be caused by the hormonal changes that may affect women during menopause. They can also help boost attention—even in folks without much experience with meditation and learning Tai Chi provides focus/attention.
• Exercise your brain. Challenging your brain by trying new things or taking on new tasks is a great way to sharpen your brain. Using brain speed training with applications is an efficient way to do this along with lifting weights, limited cardio, taking up a new hobby or sport.
• Talk to your doctor. There are a range of other things your doctor can do to help you manage your cognitive and mental health. For example, they can refer you to a psychologist to help you identify and work through emotions, thought patterns, and behaviors. Checking your labs for thyroid health, A1C and cortisol can be helpful information as well.

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Additional sources:
Menopause and women’s health: National Institute on Aging
Menopause and women’s brains: Harvard Medical School
Menopause and anxiety/depression: Sage Choice
Meditation boosts attention: Frontiers in Human Neuroscience
Alzheimer’s risk in women: Neurology
Menopause and quality of sleep: Sleep Science and Nature Neuroscience
Menopause and sleep disorders: Journal of Mid-Life Health
Sleep apnea in postmenopausal women: Menopause
Menopause and depression and anxiety risk: Australasian Psychiatry
Talk therapy: National Institute of Mental Health