Exploring Menopause’s Impact on Women's Brain Health
An illuminating NeurologyLive interview where Dr. Mosconi explains how menopause affects brain function and the importance of targeting midlife for Alzheimer’s prevention.
A main feature of menopause is the decline in the body’s production of estrogen which can lead to various bodily changes such as the cessation of menstruation, but also to neuropsychiatric effects such as “brain fog,” depression, and anxiety. A newly published brain imaging study in Scientific Reports showed that menopause transition was marked by progressively higher density of estrogen receptors (ER) in brain cells. In addition, the study pioneered the use of positron emission tomography (PET) imaging, suggesting that the technique may be a valuable tool for studying the brain effects of menopause and estrogen therapy.
In the study, lead author Lisa Mosconi, PhD, and colleagues scanned the brains of 54 healthy women aged 40-65 using PET with a tracer that binds to ERs. All told, using scans at different menopausal stages, findings displayed progressively higher ER density in several estrogen-regulated brain networks in the postmenopausal and perimenopausal groups compared with premenopausal controls. The investigators’ analyses revealed that high ER density in some of these regions was associated not only with menopause status but also with patients’ reports of menopause-related cognitive and mood symptoms.
Mosconi, an associate professor of neuroscience in neurology and radiology, and director of the Women’s Brain Initiative at Weill Cornell Medicine, recently sat down with NeurologyLive® in an interview to discuss the key neurological changes observed in women's brains during menopause. She also talked about how the new brain imaging technology developed in 2020 helps in understanding menopause's impact on the brain. Moreover, Mosconi, who also serves the director of the Alzheimer's Prevention Program at Weill Cornell Medicine and NewYork-Presbyterian, shared her reaction to the surprising findings about estrogen receptors in women's brains postmenopause.
What to read next
Hormones regulate so many of the systems in your body. At times, it seems unclear exactly what each of them accomplishes, or why certain levels of particular hormones are floating around. This conversation comes up, especially around perimenopause, and even post-menopause, when specific hormone therapies can be utilized as treatments for bothersome menopause-related symptoms like hot flashes, low energy, and low libido. Estrogen is the most common hormone used in hormone replacement therapy, also known as menopausal replacement therapy, but what about testosterone? Yes, we’re talking about that hormone, the one that’s typically known as the “male” hormone. That’s right — testosterone is found in women’s bodies (at one-tenth of the amount in men’s bodies, but still) and any people born as female. Ovaries make testosterone and technically produce it at even higher levels than estrogen. And during menopause, when the ovaries slow down in their functioning, estrogen levels lower, as do testosterone levels in the body. Just like estrogen, testosterone can be safely used as a hormone replacement therapy during menopause. Still, not many people know that, because it’s not well-studied or officially FDA-approved for women. Keep on reading for everything you didn’t know about testosterone in women, testosterone replacement therapy, and how to know if it could be the right treatment for you.
A timely Substack essay challenging outdated age-based limits for HRT and advocating for a personalized approach to hormone health.
A peer-reviewed study using PET imaging to reveal how estrogen receptor density evolves in menopausal brains—highlighting menopause as a neurological transition.