Hot flashes, insomnia, anxiety, memory lapses: these are all possible effects of menopause, but perhaps not everyone knows that they originate in the brain and that they can rightfully be defined as neurological symptoms. In fact, we are used to thinking of menopause as something that has to do solely with the reproductive system, but in reality this chapter of a woman’s life also closely concerns women’s brains. So says Lisa Mosconi, Italian-American neuroscientist, author of several scientific publications on this topic, as well as of a book entitled “The menopause brain“.
How does women’s brain change in the phases of menopause?
The results of a study published in Scientific Reports, of which Mosconi is first author, suggest for example that the different phases of the transition to menopause (identified as pre-menopause, peri-menopause and post-menopause) are characterized by substantial differences in brain connectivity and in the brain’s energy metabolism.
The study involved 161 women aged between 40 and 65, of whom 30 were pre-menopausal, 57 peri-menopausal and 74 post-menopausal. Through various types of analysis, including imaging techniques such as magnetic resonance imaging and PET (positron emission tomography), Mosconi and colleagues examined various parameters relating to the participants’ brains, including the volume occupied by gray matter and white matter, cerebral glucose metabolism, cerebral circulation and, finally, the presence of amyloid plaques. The latter are considered a risk factor for the development of Alzheimer’s disease. For comparison, the same analyses were then carried out on 125 men divided into three groups and of an age comparable to the female participants in pre-, peri- or post-menopause.
The effects of menopause
It emerged that there are differences in the observed parameters between one phase of menopause and another, confirming that menopause has effects on women’s central nervous system. The same would not be found for the three groups of male participants. In addition, the results show that peri- and post-menopausal women who have a specific variant of the APOE gene (which codes for a protein involved in lipid metabolism and already known from studies on familial Alzheimer’s) show, on average, greater deposition of amyloid plaques than men of comparable age with the same genetic variant.
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What is the role of estrogens?
As Mosconi explains in numerous articles and in her book, those responsible for the impact menopause has on the brain are above all the estrogen hormones, and in particular the fluctuations and then the decline of their levels in peri- and post-menopause, respectively. Estrogens, the neuroscientist explains, are in fact closely correlated with cognitive functions and in general with the health of the central nervous system. When their levels begin to fluctuate and then drop drastically in post-menopause, women may experience memory lapses, difficulty concentrating and all the other symptoms that, as we were saying, can be considered neurological symptoms in every respect.
How long do the effects of menopause last?
“Many of our patients have told me that they feel as if their mind is playing tricks on them, to put it mildly”, Mosconi says in a TED talk available on YouTube :
“Just to be clear: if you have ever thought this, you are not crazy. It’s important. Many women are worried about losing their minds, but the truth is that your brain is going through a transition phase and needs time and support to adapt”.
The results of the study published in Scientific Reports had in fact also shown that the parameters considered, which tend to vary from one phase of the transition to menopause to another, typically stabilize during post-menopause. Some of the typical symptoms, including hot flashes, in fact tend to disappear between two and seven years after the start of this last phase.
How to counter the effects of menopause?
“The point here is that we need to better understand what happens to our brain when we enter menopause — Mosconi continues — and how to protect it during this process”. Beyond the possible use of hormone therapies, which naturally requires the consultation and prescription of a physician, Mosconi stresses that there are many measures that can be taken into account, and that concern lifestyle.
One is diet: “Some studies have shown that the Mediterranean diet, in particular, promotes women’s health. Women who follow this diet have a much lower risk of cognitive decline, depression, heart disease, stroke, and also have fewer hot flashes — the neuroscientist explains — The interesting aspect of this diet is that it is quite rich in foods that contain estrogens, in the form of phytoestrogens, that is, estrogens from plants”.
Another aspect to take into account, she continues, is the impact of stress. Being correlated with the production of cortisol, which counteracts estrogen levels, stress is definitely an “enemy” of brain health for women going through menopause (and not only).
“The important thing — Mosconi concludes in the TED talk — is that changing the way we understand the female brain really changes the way we take care of it and the way we frame women’s health. And the more women demand this information, the sooner we will be able to break the taboos of menopause and find solutions that really work”.
