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During menopause, which marks the end of a woman’s menstrual cycle, her ovaries stop producing the hormones estrogen and progesterone, ending the natural childbearing years. But these hormones also regulate how the brain works, and the brain manages their release – which means menopause is a neurological process. “If you think about hot flashes, night sweats, anxiety, depression, insomnia, brain fog, many of the symptoms of menopause cannot be produced directly by the ovaries,” says Lisa Mosconi. Weill is director of neurology and the Women’s Brain Initiative at Cornell Medicine. “These are brain symptoms, and we should look at the brain as something that’s just as affected by menopause as your ovaries.”

In June, Mosconi and colleagues published one of the few studies that needed to be observed in detail in the journal Scientific Reports. what happens to the brain during the menopause transition, Not just before and after. Using a variety of neuroimaging techniques, they scanned the brains of more than 160 women aged 40-65 years at different stages of transition and studied the organ’s structure, blood flow, metabolism and function; they did most of the same scans two years later. They also imaged the brains of men in the same age range. “What we find in women, not men, is that the brain changes quite a bit,” says Mosconi. “The transition of menopause does indeed lead to a whole remodeling.”

On average, women in the United States enter the menopause transition – defined as the first 12 consecutive months – at about 50 years of age; they are in postmenopause after being diagnosed. But in their 40s, they may begin to experience hormonal fluctuations. (For some women, this happens in their 30s, and as with some cancer treatments, surgical removal of the ovaries causes menopause immediately.) These fluctuations cause irregular periods and potentially a wide variety of symptoms such as hot flashes, insomnia, mood swings. Concentration problem and changes in sexual arousal. During this stage, known as perimenopause, which lasts an average of four years (but can last from a few months to decades), Mosconi and colleagues observed that their female subjects experienced both loss of gray matter (brain cells that process information) and loss. white matter (fibers that connect these cells). However, this loss stopped after menopause, and in some cases brain volume increased, although not in premenopausal size. The researchers also detected changes in how the brain metabolizes energy, but these did not affect performance on tests of memory, higher-order processing, and language. This is what the female brain “goes through and compensates for,” says Jill M. Goldstein, professor of psychiatry and medicine at Harvard Medical School and founder and executive director of the Center for Innovation in Medicine for Gender Differences at Massachusetts General. Hospital. “Adapting to the new normal”