Brain regions responsible for memory and emotion are affected by menopause, brain scans from 11,000 UK Biobank participants suggest.
Summary
Imaging scans from 11,000 UK Biobank participants have revealed that some brain regions shrink after menopause. Some of the brain regions affected, including one involved in memory formation, are also the first to become damaged by Alzheimer’s disease. This might in part explain why women have a much greater risk of developing dementia than men do.
Data on cognition, sleep and psychiatric symptoms from 125,000 UK Biobank participants showed how menopause affects mental health and wellbeing
Parts of the brain responsible for learning, forming memories and regulating emotions shrink after people go through menopause, brain scans from 11,000 UK Biobank participants suggest. These changes might be part of the reason that women are twice as likely to get Alzheimer’s disease as men are.
How menopause changes the brain
People who go through menopause – usually around the age of 50 – often experience mental ill health, brain fog and difficulties sleeping. Menopause has also been linked to struggles with memory and focus.
Researchers analysed information on cognition, sleep and mental health from 125,000 UK Biobank participants as well as brain scans from 11,000 participants. They found that women post-menopause had more severe levels of depression, anxiety and insomnia than women pre-menopause.
The brain takes quite a big hit during the menopause – it’s quite shocking that there hasn’t been a lot more research on that.
Professor Barbara Sahakian, University of Cambridge, UK
The scans revealed that certain brain regions, such as the hippocampus, shrank after menopause. The hippocampus is essential for learning and memory and is one of the first regions to be damaged by Alzheimer’s disease.
“While not the whole story, [our results] may help explain why we see almost twice as many cases of dementia in women than in men,” study leader Barbara Sahakian from the University of Cambridge, UK, said in a statement.
This doesn’t mean that menopause causes dementia or immediately affects how well the brain functions. UK Biobank participants who completed memory tasks did equally well, whether they were pre- or post-menopause.
Hormones: the good and the bad
Sahakian says she was surprised that hormone replacement therapy (HRT) didn’t protect the brain. HRT can alleviate menopause symptoms, including hot flushes and joint pain. But women who took HRT experienced the same changes in the brain as women who didn’t use HRT. The medications did, however, protect from psychomotor slowing: a decrease in reaction time that comes with menopause and is a normal part of ageing.
The results argue against the notion that hormone replacement therapy ‘causes’ depression.
Professor Ciara McCabe, University of Reading, UK
“There have been previous studies suggesting an association between HRT use and increased depression,” neuroscientist Ciara McCabe from the University of Reading, UK, told the Science Media Centre. “However, this study shows that those who have higher problems with depression and anxiety in the first place are more likely to be prescribed HRT, arguing against the notion that HRT ‘causes’ depression,” she explained.
Stress as a driver
Why menopause affects the brain in the way it does isn’t clear yet. “We know that chronic stress can shrink the hippocampus,” Sahakian says. “It may be that during this period of time there’s a lot of stress, and that may be the root by which the menopause, in part, is causing some of these problems.”
Sahakian suggests that those who are struggling with menopause should seek help as quickly as possible. “Many mental health problems are very treatable provided you get help early,” she says.
The discovery that menopause affects certain brain areas, “highlights the need to investigate whether anything can be done to predict or treat this”, Channa Jayasena, who researches reproductive endocrinology at Imperial College London, UK, told the Science Media Centre.
Sahakian agrees: “The brain takes quite a big hit during the menopause, and I think it’s quite shocking that there hasn’t been a lot more research on that.”
This research was covered in the BBC, The Times, Sky News, The Independent, The i Paper, Women’s Health and Technology Networks. Sahakian and her colleague Christelle Langley wrote about their work in The Conversation.
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