Menopause may be associated with measurable changes in brain structure, alongside higher rates of anxiety, depression and sleep disruption, according to new research led by the University of Cambridge using UK Biobank data.
In a large sample of women, researchers reported lower grey matter volume in several brain regions after menopause, patterns that were broadly similar whether or not participants had used hormone replacement therapy, commonly known as HRT.
What the researchers analyzed
The team examined questionnaire, health and cognitive testing data from nearly 125 000 women in the UK Biobank, a long-running project that links health records with detailed participant assessments.
They also reviewed brain MRI scans from around 11 000 women, allowing comparisons between those who were pre-menopause, post-menopause without HRT use, and post-menopause with HRT use.
Mental health and sleep symptoms
Across the dataset, women who had gone through menopause were more likely to report seeking medical help for anxiety, nervousness or depression, and they were more likely to report persistent sleep problems such as insomnia and fatigue.
Women who used HRT showed higher levels of anxiety and depression than non-users, but the analysis suggested these differences often existed before menopause, indicating HRT may have been prescribed to people already experiencing symptoms.
Brain regions tied to memory and emotion
Imaging results showed reduced grey matter volume after menopause in areas involved in memory and emotional regulation, including the hippocampus, entorhinal cortex and anterior cingulate cortex.
Because some of these regions are also affected early in Alzheimer’s disease, the findings add to ongoing research into why women are diagnosed with dementia more often than men, though the study does not prove menopause causes dementia.
On cognitive testing, memory scores were broadly similar across groups, but reaction time tended to be slower after menopause, with evidence that HRT use was associated with a smaller decline in reaction speed.
The authors emphasized that menopause can be a major health transition and argued for greater attention to mental health support, sleep and lifestyle measures such as exercise and diet, alongside individualized medical advice about HRT.
The study was published in Psychological Medicine, and the researchers noted that further work is needed to clarify how hormone changes, symptom severity, HRT timing and other health factors interact with brain ageing.
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