Menopause May Cause Brain Changes, Increase Risk Of Anxiety and Sleep Problems: Study

Menopause is a period when your menstrual period stops. It occurs between ages 45 and 55 and is usually accompanied by hot flushes, low mood, and disrupted sleep, among others. Menopause is known to impact health in several ways. A new study found that menopause can cause changes in the brain structure. It also revealed that there were higher levels of anxiety, depression, and sleep difficulties, along with reduced grey matter volume in several important brain regions. The study was conducted by the University of Cambridge and published in Psychological Medicine. Researchers also studied how hormone replacement therapy (HRT) impacted these changes. They found that HRT doesn't prevent these changes, however, it slows the decline.

Earlier studies have linked how menopause impacts cognitive abilities, including memory, attention, and language. For the new study, the team used data from the UK Biobank which included nearly 125,000 women. The researchers divided the participants into three groups; women who had not yet reached menopause, women who were post-menopause and had never used HRT, and women who were post-menopause and had used HRT. The average age of menopause among the participants was about 49.5 years.

Menopause, Mental Health, and Brain Structure

The participants then completed questionnaires about menopause symptoms, mental health, sleep patterns, and overall health. Some of these participants also finished cognitive tests which measured their memory and reaction time. Nearly 11,000 of them underwent magnetic resonance imaging (MRI) scans. These scans allowed researchers to examine differences in brain structure.

Post-menopausal women were more prone than pre-menopausal women to consult a GP or psychiatrist for anxiety, nervousness, or depression. They also had higher scores on depression scales and a higher chance of receiving antidepressant prescriptions.

Anxiety, Depression, and Sleep Disruptions Rise After Menopause

Women receiving HRT showed higher anxiety and depression levels than those not using HRT. However, further analysis showed that these differences existed prior to the onset of menopause onset. Sleep disturbances increased after menopause. Postmenopausal women more frequently reported insomnia, shorter sleep duration, and persistent fatigue. On the other hand, HRT users were the most fatigued among all groups, despite similar sleep hours with non-HRT post-menopausal women.

Experts Stress the Need for Greater Support During Menopause

Dr. Christelle Langley from the Department of Psychiatry said, "Most women will go through menopause, and it can be a life-changing event, whether they take HRT or not. A healthy lifestyle -- exercising, keeping active and eating a healthy diet, for example -- is particularly important during this period to help mitigate some of its effects.

"We all need to be more sensitive to not only the physical, but also the mental health of women during menopause, however, and recognize when they are struggling. There should be no embarrassment in letting others know what you're going through and asking for help."

Cognitive Decline and Brain Changes Linked to Menopause

The study also found that menopause impacted cognitive performance. Post-menopausal women who were not using HRT had a slower reaction when compared to the ones who had not yet reached menopause and those who were using HRT.

Dr. Katharina Zuhlsdorff from the Department of Psychology at the University of Cambridge, said, "As we age, our reaction times tend to get slower -- it's just a part of the natural ageing process and it happens to both women and men. You can imagine being asked a question at a quiz -- while you might still arrive at the correct answer as your younger self, younger people would no doubt get there much faster. Menopause seems to accelerate this process, but HRT appears to put the brakes on, slowing the ageing process slightly."

The team also conducted MRI of the brain, which revealed that post-menopausal women had significant reductions in grey matter volume, regardless of whether they had used HRT. The most affected areas of the brain were the hippocampus, the entorhinal cortex, and the anterior cingulate cortex.

Professor Barbara Sahakian, the study's senior author from the Department of Psychiatry, said, "The brain regions where we saw these differences are ones that tend to be affected by Alzheimer's disease. Menopause could make these women vulnerable further down the line. While not the whole story, it may help explain why we see almost twice as many cases of dementia in women than in men."

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