Research shows that menopause reduces the volume of gray matter in key areas of the brain, which may increase vulnerability to dementia.
Menopause is associated with a reduction in gray matter volume in key regions of the brain, as well as the higher levels of anxiety and depression and sleep disturbancesconcludes the investigation.
A critical period in women’s lives
A It is a remarkable phase in a woman’s life, characterized by the end of menstruation due to a decrease in hormonal levels. It generally appears between the ages of 45 and 55 and is associated with symptoms such as hot flashes, mood changes and sleep problems. Previous studies had already linked menopause with cognitive decline, particularly in terms of memory, attention and language.
To alleviate some of these symptoms, particularly depressive symptoms and sleep disorders, many women resort to . However, the effects of menopause and the use of this therapy on the brain, cognition and remain unclear.
Data from almost 125 thousand women in England
To delve deeper into these questions, researchers at the University of Cambridge analyzed data from the UK Biobank on around 125,000 women in England. Participants were divided into three groups: premenopausal women, postmenopausal women who have never used HRT and postmenopausal women who have used this therapy.
In England, in 2023, around 15% of women will receive a prescription for TSH.
Participants answered questionnaires about their experience of menopause, self-reported mental health, sleep patterns and general health status. One part performed cognitive tests, including assessments of memory and reaction time. Around 11,000 women were also subjected to MRI exams, allowing the brain structure to be analyzed.
The average age at onset of menopause was approximately 49.5 years. Among women who used HRT, treatment began, on average, at 49 years of age.
Brain changes in regions linked to Alzheimer’s
One of the most relevant results of the study concerns structural changes in the brain. In both groups of postmenopausal women, researchers identified significant reductions in gray matter volume, brain tissue essential for information processing, memory, movement control and emotion regulation.
These changes were detected in three specific regions:
- in the hippocampus, involved in the formation and storage of memories;
- in the entorhinal cortex, fundamental in the connection between the hippocampus and the rest of the brain;
- in the anterior cingulate cortex, associated with attention, decision-making and emotional regulation.
Professor Barbara Sahakian, senior author of the study and researcher at the Department of Psychiatry at the University of Cambridge, highlights that These are precisely the brain regions that tend to be affected in the early stages of Alzheimer’s disease.
“The brain regions where we observe these differences are those that tend to be affected by Alzheimer’s disease. Alzheimer. Menopause can make these women more vulnerable (to the development of dementia) in the future. While it doesn’t explain everything, this may help explain why we see almost twice as many cases of dementia in women as in men.”
Mental health and sleep most affected after menopause
Postmenopausal women were more likely to have sought medical support due to anxiety, nervousness or depression, compared to premenopausal women. They also scored higher on questionnaires about depressive symptoms and were more likely to have been prescribed antidepressants.
Although the group that did TSH presented higher levels of anxiety and depression than the group that did not use this therapy, additional analyzes suggest that these differences already existed before menopause. According to the researchers, it is possible that, in some cases, TSH was prescribed in anticipation of a worsening of symptoms with the menopausal transition.
Sleep and tiredness
When it comes to sleep, postmenopausal women more frequently reported insomnia, fewer hours of sleep and greater tiredness. Women taking HRT reported feeling more tired than the other two groups, although there were no differences in sleep duration between postmenopausal women with and without HRT.
“Most women will go through menopause, and this can be a life-changing event, regardless of whether they take HRT or not. A healthy lifestyle – with exercise, physical activity and a balanced diet, for example – is particularly important during this period to help mitigate some of its effects,” he says. Christelle Langley, from the Department of Psychiatry at the University of Cambridge.
“We all need to be more sensitive not only to the physical health, but also to the mental health of women during menopause and recognize when they are struggling. There should be no embarrassment in sharing what you are going through and asking for help.”
Cognitive impact: slower reaction time
The research also revealed effects at the level of cognition. To the postmenopausal women who were not taking HRT showed slower reaction times than premenopausal women and those who used hormonal therapy. However, no significant differences were found between the three groups in the memory tasks.
Katharina Zühlsdorff, from the Department of Psychology at the University of Cambridge, explains that the Slowing reaction time is part of normal aging in men and women, more than Menopause appears to accelerate this process.
“As we age, our reaction times tend to slow down – this is part of the natural aging process and happens to both women and men. Imagine being asked a question on a quiz – although you might still get to the correct answer as you did when you were younger, younger people would certainly get there much more quickly. Menopause appears to speed up this process, but TSH appears to slow it down, slightly slowing down the aging process.”
Gray matter and white matter
Gray matter and white matter are essential components of the brain and spinal cord. The gray matter It is made up of the cell bodies of neurons and their dendrites, responsible for local communication between nerve cells.
The white substance It is made up mainly of axons, long structures that allow the transmission of nerve impulses between more distant regions of the brain and spinal cord.
