Exploring the connection between menopause and the brain

You know that feeling when you start a sentence and mid-way through, you can’t remember what you were saying?

Well, if you’re female and these little lapses in memory are happening during your midlife years, there are two things you should know.

1. It’s not all in your mind.
   
   
2. It is mostly in your brain, though. 

In this coaching article, we’ll be putting on our detective hats as we examine how your brain actually undergoes significant changes during the menopause. 

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Oestrogen’s journey: premenopause, perimenopause, menopause and  postmenopause

The sex hormone oestrogen is probably most well known for triggering puberty and its roles in the menstrual cycle and fertility in young people with wombs. 

However, its effects in the body are far more wide-ranging across the lifespan. Whatever your age, oestrogen is also responsible for:

• Bone strength
  
  
• Maintaining normal cholesterol levels
  
  
• Bladder control
  
  
• Mood regulation
  
  
• Protecting heart and brain health

Between the ages of 45 and 55, oestrogen levels in women and people assigned female at birth start to drop.  Eventually, a woman will reach menopause: the point in time 12 months after a woman’s last period.

This could also happen earlier in life if you’ve had surgery to remove your ovaries (oophorectomy) or uterus (hysterectomy).

Menopause doesn’t happen overnight. Perimenopause - the time leading up to menopause - can begin 8 to 10 years ahead as your ovaries gradually produce less oestrogen. It consists of menopausal symptoms that take place while you are still menstruating due to your oestrogen levels decreasing.

Although oestrogen is our main suspect,  other partners-in-crime that also decrease with age are the hormones progesterone, testosterone, follicle-stimulating hormone and luteinising hormone. 

Let’s look at how this hormone drop leads to changes in your brain.

How the signs and symptoms of the menopause reveal a connection to the brain

Although the scientific community has recognised the intertwined connection between ovarian and brain health for decades, this is still a deeply misunderstood topic in the general population. 

To solve this mystery once and for all, we have three symptomatic clues that we’ll be investigating:

• Hot flashes
  
  
• Brain fog and altered mood
  
  
• Sleep disturbances 

Most people are aware these are the symptoms, but do you know what’s going on under the hood?

Let’s investigate each lead to reveal the neurological connection
between your declining hormones and your brain. 

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Clue #1: Hot flashes 

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Our first clue is one of the most well-known symptoms of the menopause: hot flashes. 

A drop in oestrogen can negatively affect the hypothalamus, the thermostat in our brain that regulates body temperature. 

When your thermostat malfunctions, the result can be a sudden onset of feeling hot in your face, neck and chest, often leading to dizziness. 

Research estimates 73% of women go through this during the menopause. 

Clue #2: Brain fog and altered mood

For our second clue, we need to look at the areas of the brain that play vital roles in concentration, memory and mood. 

This comes down to two areas: the amygdala and the hippocampus.

These two brain structures are jam-packed with oestrogen receptors and therefore can be  strongly affected by the menopause.

When these regions are forced to function with less oestrogen than usual, you can end up with reduced self-esteem, low mood, anxiety and a host of memory issues. 

If this is you, you’re not alone. 

A study has shown that up to 72% of women going through the menopause report battling to remember names, with half of the women battling to remember where they put things or what they were doing. 

Hot flashes can exacerbate this memory impairment as they can cause a reduction of blood flow to the brain, making recalling specific facts even harder. 

Clue #3: Sleep disturbances 

Our final clue has to do with one of the five pillars of brain health: sleep. 

As oestrogen decreases, the parts of our brain that control our sleep and wake cycles (the brainstem and hypothalamus) fail to function properly, resulting in trouble sleeping. 

Menopause symptoms can tend to compound. For example, you might experience night sweats where you undergo hot flashes during your sleep, which can cause further sleep disruption. 

This lack of sleep leads to more mood disturbances on top of those already being caused by the brain’s reaction to the lack of oestrogen. 

The final puzzle piece

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Even though we’ve examined the clues connecting the experience of the menopause to the brain, we still need to connect one more dot before we can wrap up our investigation. 

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And that dot is the connection between Alzheimer’s risk and the menopause.

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There are double the number of women with Alzheimer’s disease than men. 

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Research has found that 40-60-year-old perimenopausal and postmenopausal women have far greater levels of a type of brain plaque that is considered a hallmark sign associated with Alzheimer’s disease.  

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This does not mean that all women going through the menopause will develop Alzheimer’s, but rather that women have an increased risk due to the effect that the menopause has on the brain. 

Watch this TED talk by Neuroscientist Dr Lisa Mosconi to learn more about the menopause-brain connection. 

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Hormone Replacement Therapy (HRT) for the menopause

Hormone replacement therapy is a treatment to reduce the symptoms associated with the menopause. 

It involves taking hormones such as oestrogen, progesterone and testosterone. This can be done in several ways, such as tablets, patches, gels and implants.

When it comes to HRT, a hot topic always seems to be the side effects.

Whenever it comes to any medication, there are always risks of side effects happening, but these risks are often massively blown out of proportion within the media. 

For the majority of women, HRT is a safe and effective treatment for the menopause. 

According to the NHS, side effects could be issues such as:

• Weight gain
  
  
• Headaches
  
  
• Bloating
  
  
• Swelling and tenderness
  
  
• Mood changes

While potentially unpleasant, these side effects will usually pass after a few weeks as your body adjusts to the new status quo. If side effects persist, your GP should be able to work with you to adjust your medication type or dosage. Speak to your GP to help you to choose the right type of HRT for you. 

Davina Mccall: Sex, Mind and the Menopause

Just a few decades ago, topics such as the menopause and menstruation were considered completely taboo, and information was hard to come by.

Now that we live in the information age, the impact of the menopause on the mind is finally getting the attention it deserves. Just take a look at Channel 4’s highly-rated documentary “Davina Mccall: Sex, Mind and the Menopause”, which caused quite a stir in our office.

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The synopsis goes:

“Davina explores how menopause can affect the mind as well as the body, with memory loss and brain fog decimating women at work. And the latest on hormone therapy and women and testosterone.”

The documentary is worth a watch as it reveals the everyday situations and struggles that half of the population on the planet either has gone through, is going through or will most likely go through.

Case solved!

Thank you for solving this case with us, detective!

We can now see that the menopause is your body and brain reshaping itself as an adaptive process to deal with the natural ageing process.

Feel free to dive into more cases with us as we continue on our journey to better brain health. 

Looking for a lifestyle coach that prioritises your brain health?

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Download our medically validated app today to assess your brain health, gauge your lifestyle factors, and get guidance from our digital coach on how to improve the five areas vital to reducing your risk for dementia.

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