Menopause reshapes the brain in surprising ways — but it may also reveal the brain’s remarkable ability to adapt.
During menopause, many women notice episodes of “brain fog,” which can include forgetfulness, difficulty focusing, and persistent mental tiredness. These challenges are often linked to shifting hormone levels. To better understand what is happening in the brain during this life stage, researchers reviewed previously published studies examining how structural brain changes relate to cognitive, emotional, and physical health outcomes. Their findings were presented at the 2025 Annual Meeting of The Menopause Society.
Structural Brain Changes During Menopause
Scientific evidence shows that menopause is tied to measurable alterations in brain structure. Several studies report decreases in gray matter volume in the frontal and temporal cortices as well as the hippocampus, regions that play central roles in memory and higher-level thinking skills. These reductions in brain volume have been associated with declines in cognitive abilities, particularly verbal memory and visuospatial memory.
White Matter Hyperintensities and Neurological Risks
Research has also identified an increase in white matter hyperintensities, especially in women who experience early menopause or frequent hot flashes. White matter hyperintensities appear as bright areas on MRI scans of the brain’s white matter and typically signal tissue damage caused by reduced blood flow. These abnormalities are linked to symptoms such as cognitive decline, balance difficulties, and mood changes. They are also associated with a greater risk of stroke and dementia.
Brain Recovery, Estrogen Receptors, and Neural Adaptation
Some studies suggest that gray matter volume may partially rebound after menopause, which could reflect the brain’s ability to adapt through neuroplasticity. Researchers have also observed higher estrogen receptor density during the menopause transition. This increase may be the brain’s way of responding to declining hormone levels, although it has also been connected to poorer memory performance. Alterations in cerebrovascular reactivity and changes in brain energy metabolism further highlight how menopause can affect neural health and resilience.
Research From the BRAVE Lab
At the BRAVE Lab within the School of Behavioral and Brain Sciences at Ponce Health Sciences University (Puerto Rico), PhD-PSY students Angélica Rodríguez and Andrea Pereira conducted a comprehensive bibliographical review under the supervision of Dr. Bárbara Barros and Dr. Karla Martínez. Their analysis focused on scientific studies exploring structural brain changes linked to menopause and how these changes may help explain common symptoms. Expanded findings will be shared at the 2025 Annual Meeting of The Menopause Society in a poster presentation titled “Menopause and Brain Structural Changes: A bibliographic revision.” Rodríguez, the first author, will present the poster at the conference.
Why Continued Research Matters
“This type of work highlights the need to continue exploring the relationship between the brain and menopause, particularly their connection with the cognitive, emotional, and behavioral symptoms women experience during this stage,” says Angélica Rodríguez, PhD student in Psychology at Ponce Health Sciences University in Puerto Rico.
Toward Better Understanding and Therapies
“This study represents the cumulative body of scientific knowledge relative to structural changes that take place in the brain during menopause,” says Dr. Stephanie Faubion, medical director for The Menopause Society. “These data will hopefully lead to a better understanding of the factors underlying some of the cognitive concerns experienced by women during the menopause transition so that we can ultimately identify effective therapies.”
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