Many women report increased forgetfulness and “brain fog” during the menopause transition.
In addition to chronological aging, women experience reproductive aging in early middle age, menopause, during which they experience a decline over time in ovarian hormones such as estradiol, the primary form of estrogen that acts in the brain. Studies have shown that estradiol is directly related to changes in memory performance and the reorganization of brain circuits that regulate memory function.
Therefore, women and men go through different aging processes, especially in early middle age, when reproductive aging is more critical for them than chronological aging. However, cognitive aging is rarely considered a health issue for women.
On average, women perform better than men on measures of verbal memory, starting as early as post-puberty. However, this advantage diminishes with menopause. Many report increased forgetfulness and “brain fog” during the menopause transition. Over the past 15 years, a growing body of research has outlined the complex ways menopause affects the brain and what helps keep memory intact. Menopause also reduces the level of glucose in the brain, the primary fuel used by brain cells. The brain then turns to other metabolic sources to provide the fuel it needs to function, that is, it adapts to a new hormonal environment to maintain function.
Additionally, women with other medical conditions, such as diabetes and high blood pressure, are at increased risk for cognitive decline. Research to understand this focuses, in part, on how the brain and body share similar processes to produce energy for functioning (metabolism) and how blood pressure and other aspects of the vascular system function similarly in the brain and body.
Increase in receptors
Now, some answers may be emerging. According to data found in a new study published in the journal Nature At the end of June, when women enter menopause, the number of estrogen receptors in the brain increases. Igor Padovesi, a member of the North American Menopause Society (NAMS) and the International Menopause Society (IMS), says that, contrary to what theories suggest, estrogen receptors in the brain are not deactivated after menopause.
She explains that estrogen is a key hormone in the female reproductive system and brain function. 17β-estradiol (E2), the most active form, affects brain processes such as cognition and aging by acting on estrogen receptors in the brain. As women enter menopause, E2 levels decline, affecting these brain functions and causing what has become known as “brain fog.”
The study examined 54 healthy women between the ages of 40 and 65 who were premenopausal, perimenopausal, or postmenopausal. They also underwent MRI scans, blood tests for hormone levels, and questionnaires about menopause symptoms.
“The researchers found that as women progress through menopause, the density of estrogen receptors in the brain increases, peaking post-menopause. Significant differences in the density of these receptors were observed in key areas of the brain, such as the pituitary gland and the caudate nucleus. These changes were not influenced by age, but were associated with menopausal status,” the gynecologist comments.
Missing hormone
Padovesi states that the increase in estrogen receptors in the brain indicates precisely the lack of estrogen. This is the body’s response to the lack of this hormone and this is proof of the effect of the importance of estrogen on brain activity and function, so much so that when it ends after menopause, the receptors increase in the body’s attempt to rebalance it, in a negative feedback mechanism (when something is missing, the body tries to increase the receptors with the intention of taking what little is left).
“So the increase in receptors is an indication of a hormone deficiency. For the first time, it has been possible to successfully measure estrogen activity in the living human brain. This marks a significant step forward in science and medicine, especially in understanding how estrogen affects brain health,” adds the doctor.
She points out that until then, there were no technologies to directly measure estrogen activity in the brain. To fill this gap, researchers pioneered the application of 16α-18F-fluoro-17β-estradiol positron emission tomography (PET), a technique previously reserved for oncology, to brain studies. The study also found that a higher density of estrogen receptors in the brain can tell whether a woman is premenopausal or postmenopausal, and that it correlates with lower memory scores and cognitive and mood problems in postmenopausal women.
Hormone replacement
Overall, the study highlights how menopause influences the distribution of estrogen receptors in the brain and its impact on cognitive and mood symptoms.
“This profoundly changes our understanding of how the brain responds to menopause. Furthermore, the finding that these receptors remain active in the brain for up to a decade after menopause suggests that the ‘window of opportunity’ for estrogen replacement therapy may be greater than previously thought, making it essential to consult a gynecologist who specializes in this area for evaluation and, if indicated, hormone replacement therapy with appropriate monitoring, thus ensuring the safety and effectiveness of the treatment,” concludes Padovesi.
National research
On the Issviva website, a brand of the Swedish Essity group dedicated to demystifying and breaking taboos related to menopause, there is still an active research, in the form of a quiz, which also provides some confirmations on menopause and memory loss. The survey, which began on March 21, 2023, has so far interviewed 99,902 Brazilian women. Memory loss was highlighted by 77% as a problem related to menopause. Other mental and emotional health symptoms reported were mental confusion in 25%, depression in 40%, anxiety in 83% and mood changes in 87%. The option “none of the above” was chosen by 4%.
Studies show that memory problems increase with age and become more latent during menopause. In addition, there are factors that intensify the symptoms, such as the aforementioned reduction in estrogen levels, sleep disturbances, fatigue, acute stress, anxiety, mood swings, chronic depression, chemotherapy, vitamin B12 deficiency, low levels of hormones produced by the body thyroid, smoking, sedentary lifestyle and night sweats.
In addition to affecting physical and mental health, memory loss also affects professional life. In surveys already carried out by the Essity Group, 62% of women worked full-time, 18% worked part-time, 8% had a period of leave due to menopause and 54% told their employer the reason for the leave. The symptom of memory loss also alters and intensifies other factors, so it is to be considered important at a time when the woman is exhausted and needs to withdraw to take care of herself.
Other menopause-related topics investigated in the research include the frequency of symptoms such as tiredness, bloating, hot flashes, night sweats, muscle pain, shortness of breath, headaches, joint stiffness, sleep disturbances, bone weakness, dizziness, as well as symptoms related to sexual well-being and pleasure (urinary tract infections, urinary incontinence, urine leakage, decreased libido, vaginal dryness, among others) and self-image and beauty symptoms (skin problems, hair loss, weight gain, and others).
Sources: Harvard Health / Long live / Igor Padovesi: gynecologist, senior member of the European Society of Aesthetic Gynecology (ESAG), the North American Menopause Society (NAMS), Associate of the Brazilian Federation of Gynecology and Obstetrics Associations (Febrasgo) @dr.igorpadovesi
Source: Terra
Ben Stock is a lifestyle journalist and author at Gossipify. He writes about topics such as health, wellness, travel, food and home decor. He provides practical advice and inspiration to improve well-being, keeps readers up to date with latest lifestyle news and trends, known for his engaging writing style, in-depth analysis and unique perspectives.
