Brain Changes In Menopause May Leave Women 'Vulnerable' To Dementia

About twice as many women as men experience dementia. Researchers don’t know for sure why that is, though Ayesha Sherzai, neurologist and codirector of the Brain Health and Alzheimer’s Prevention Programme at Loma Linda University Medical Centre, previously said hormones may play a role.

“Oestrogen is a very important factor in memory creation and in brain health,” she said.Some think its decline in menopause may affect our risk.

A new Cambridge study, which analysed 125,000 participants in the UK Biobank, found that “menopause is linked to adverse mental health outcomes and reductions in grey matter volume in key brain regions”. 

What did the study say?

In this paper, scientists found that women’s grey matter – parts of the brain linked to memory, emotional regulation, and mental function – seemed to shrink after menopause. 

They also found that “Menopause was associated with increased levels of anxiety, depression, and sleep difficulties,” and that women who took hormone replacement therapy (HRT) appeared to experience these symptoms more severely. 

However, the women who took HRT also had more of these issues before menopause, too. They also seemed to have less grey matter on average after menopause.

The study’s senior author, Professor Barbara Sahakian, said, “The brain regions where we saw these differences are ones that tend to be affected by Alzheimer’s disease.

“Menopause could make these women vulnerable further down the line. While not the whole story, it may help explain why we see almost twice as many cases of dementia in women than in men”. 

Does this mean menopause definitely causes dementia? 

Speaking to HuffPost UK, Dr Charis Chambers, chief medical officer at Clue and board-certified OBGYN, said: “It’s unclear whether these changes to the brain might be longer lasting without having long-term studies.

“Because HRT use doesn’t appear to mitigate these changes, and they may be due to underlying baseline differences, one might expect them to be persistent.” 

And while HRT appeared to be linked to mental and brain changes in this study, Dr Chambers stressed, “This study doesn’t have enough evidence to show that HRT affected anything, really.”

Links like a higher incidence of mental health issues and a greater reduction in grey matter are “an association and may be explained in part by the findings of their post-hoc analyses, which showed higher levels of pre-existing mental health symptoms in women who are prescribed HRT.

“This means it’s possible that women with pre-existing mental health symptoms are at greater risk of greater mental health challenges in menopause, which would make them more likely to seek treatment and ultimately be prescribed HRT.

“It’s also possible that grey matter generally decreases in menopause, and those with more pronounced mental health challenges have more brain differences due to their underlying baseline difference.” 

Depression and dementia have previously been linked, for instance.

“The benefits of HRT are well established. HRT provides effective relief of vasomotor symptoms, reduces osteoporotic fractures, and treats genitourinary syndrome of menopause.” 

Speak to your GP if you’re struggling with symptoms of menopause 

“If anyone is struggling with mental health challenges in or outside of the context of menopause, it’s important that they don’t ignore their symptoms.

“Reach out to your qualified health care provider to learn your options,” Dr Chambers added.