Our Brain During Menopause

Many women worry that the brain fog and memory loss symptoms they experience during Menopause are early onset dementia or will lead to Alzheimer’s, but as Lara Briden states, this should be temporary while your brain adjusts.

“In simplest terms, Oestrogen helps brain cells use Glucose for energy and moving to the lower Oestrogen state of Menopause can result in an up to 25% drop in the energy and activity of the brain. 

The drop will be even greater if you underwent surgical Menopause and therefore don’t have ovaries to provide Oestrogen and Androgen precursors. 

It’s basically a temporary “energy crisis” while your brain adjusts and recalibrates. 

Successful recalibration should restore normal brain energy and put you on the road to a healthy midlife brain. 

Unsuccessful recalibration could, unfortunately, prolong the low energy state and be a tipping point towards a longer-term risk of cognitive decline”- Lara Briden.

Typical Cognitive Symptoms During Peri-Menopause

  • Brain Fog
  • Lack of concentration
  • Lack of sharpness
  • Trouble finding words
  • Forgetfulness
  • Lack of mental stamina + energy

Personally, I had EVERY one of these symptoms, plus I felt like I was operating in slow motion, you know, the six-million dollar man slow-mo run. 

And I know this audience will get the reference. 

Other signs of Mild Cognitive Impairment (MCI) that you may notice include –

  • You forget things more often.
  • You forget important events such as appointments or social engagements.
  • You lose your train of thought or the thread of conversations, books or movies.
  • You feel increasingly overwhelmed by making decisions, planning steps to accomplish a task or understanding instructions.
  • You start to have trouble finding your way around familiar environments.
  • You become more impulsive or show increasingly poor judgment.
  • Your family and friends notice any of these changes.
  • You may also experience depression, irritability and aggression, anxiety and apathy.

Another study supports Lara’s conclusion.  The menopause transition and women’s health at midlife: a progress report from the Study of Women’s Health Across the Nation (SWAN)

Approximately 60% of midlife women report problems with memory during the Menopause Transition. 

Yet, studies of measured cognitive performance during the transition are rare.

To address unanswered questions about midlife cognitive function, the SWAN protocol included in-person serial tests of cognitive processing speed, verbal memory, and working memory. 

SWAN’s initial, 4-year analysis of the relationship between the Menopause Transition and cognitive performance disclosed a temporary decline in both processing speed and verbal memory during the peri-menopause; this resolved in postmenopause

The negative peri-menopause effect was subtle, manifest as the absence of a learning effect, meaning that cognitive test scores did not improve with repeated administrations.

Improvement with repeated testing is normative in this age range, But even in peri-menopause, test scores did not drop—they simply did not improve during this Menopause Transition stage. 

It is important to distinguish between not getting better and an actual decline.

What is the reason for these issues going on in our brains? You guessed it….Estrogen! or reducing levels

Estrogen promotes the uptake of Glucose and its metabolism in the brain.  

When we go through Menopause and our estrogen declines, so do the glucose levels in our brains. 

And although the brain makes up about 2% of a person’s body weight, it uses 20% of our Glucose.

Estrogen works as a master regulator, ensuring the brain responds correctly to coordinate signalling and regulate energy metabolism.

Remember, practically every cell in your body, including your brain, has estrogen receptors.

Another cause, also related to reducing Estrogen, is increased Inflammation.  

All of our Sex Hormones are natural anti-inflammatories, and as we transition, we go into a more inflamed state.

These pro-inflammatory processes appear to compromise Estrogen’s role in protecting the brain from damage and compromise mitochondrial functions.

FYI – The mitochondria are the cell’s powerhouses; maintaining normal mitochondrial function is crucial for cell survival. 

Another study-The, peri-menopause in a Woman’s Life: a systemic inflammatory phase that enables later neurodegenerative disease by Micheline McCarthy & Ami P. Raval, states –

Emerging evidence is showing that peri-menopause is pro-inflammatory and disrupts estrogen-regulated neurological systems. 

Estrogen is a master regulator that functions through a network of estrogen receptor subtypes alpha (ER-α) and beta (ER-β). 

Estrogen receptor-beta has been shown to regulate a key component of the innate immune response known as the inflammasome, and it also is involved in the regulation of neuronal mitochondrial function. 

This review will present an overview of the menopausal transition as an inflammatory event, with associated systemic and central nervous system inflammation, plus the regulation of the innate immune response by ER-β-

Estrogen affects how your brain grows and functions, which is why experts like Dr Lisa Mosconi, author of The XX Brain and Director of the Women’s Brain Initiative, believe that Menopause can be a turning point for brain health and cognitive function. Dr Mosconi explains: 

Estrogen stimulates the brain, keeps the neurons firing, supports the growth of new cells and helps existing cells to form new connections.  

When estrogen levels fall during the menopause transition, your entire body – including your brain – goes into a deprivation state.  

We have found that there is an overall reduction of brain energy levels during Menopause, which might be one reason why you can suffer hot flushes, night sweats, anxiety, depression, brain fog, and even memory loss.”

She adds: “Testosterone has similar functions but, in men, it declines very gradually over time. In many cases, men are fertile into old age. 

But Estrogen really goes away during Menopause – suddenly, your most potent Estrogen is gone. For some women, it can happen almost overnight if you have surgery, and sometimes due to cancer treatment, and that’s a shock.  

Many people see Menopause as a natural process we go through, which is absolutely correct. But they don’t see it as a process that puts you at an increased risk of future conditions – including dementia – and this is what’s really key.”

Other ways Estrogen benefits our brain –

  • Protects nerve cells by preventing dangerous build-up of calcium within the cells
  • Stimulates nerve cell growth, regenerates axons, and decreases nerve cell death that happens in Alzheimer’s
  • Reduces the production of beta-amyloid, the substance that accumulates in amyloid plaques (present in Alzheimer’s); it also protects brain cells from damage by beta-amyloid
  • Prevents the build-up of Tau tangles (present in Alzheimer’s)
  • Enhances the ability of neurons to survive toxic insults such as inflammatory responses
  • Makes brain cells more responsive to the effects of nerve growth factor, a protein needed for the development of new neurons and the health of existing ones
  • Improves cerebral blood flow

Have you heard of Neuroplasticity? 

Neuroplasticity means that Neurons are capable of forming new connections throughout our life.  

Laboratory studies have suggested that Estrogen can enhance Neuroplasticity by modifying the structure of nerve cells in the brain and altering the way they communicate with each other.

We are NEVER too old to learn new things.

As Estrogen supports brain function, increasing evidence suggests that taking HRT could also play a key role in reducing the risk of dementia.  

Research from the University of Arizona Center for Innovation in Brain Science found that people who took HRT went on to have a 58% lower risk of Alzheimer’s. 

Dr Roberta Diaz Brinton says: 

“The key is that hormone therapy is not a treatment, but it’s keeping the brain and this whole system functioning, leading to prevention. It’s not reversing disease; it’s preventing disease by keeping the brain healthy.”

Action steps we can take


  • Stress
  • Alcohol
  • Blood sugar fluctuations


  • Sleep
  • Movement and muscle
  • Gut Health
  • Brain nourishment-See Flavonoids below


  • Meditation and Yoga
  • Water, water and then more water
  • Joy and Fun
  • Variety and challenges

Flavonoids for Cognitive Health

Foods rich in flavonoids

  • Berries – Strawberries/Raspberries/Blueberries
  • Drinks – Red Wine/Green Tea/Black Tea
  • Veggies – Red cabbage/Kale

As you can see, the symptoms relating to our brain during peri-menopause are usually temporary and should resolve themselves post-Menopause.

But that does not mean you need to wait it out. If these symptoms are affecting your day-to-day life, please seek help.

From personal experience, HRT resolved my cognitive symptoms in a very short space of time.

Want to learn more about Estrogen? check out the post Why Estrogen Matter

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