"It is thought that hormones may play a role."
A major UK study has linked menopause to brain changes similar to those seen in Alzheimer’s disease, raising fresh questions about women’s long-term cognitive health.
Researchers found that menopause is associated with grey matter loss in areas responsible for memory, perception, emotion and learning.
They suggest these changes may partly explain why women face a higher dementia risk than men.
The findings come from nearly 125,000 women, including around 11,000 who underwent MRI brain scans.
The research was published in the journal Psychological Medicine and offers one of the largest datasets exploring menopause and brain structure.
Scientists observed grey matter loss in several key regions of the brain.
These included the hippocampus, which plays a major role in learning and memory.
They also identified changes in the entorhinal cortex, a region essential for memory formation and spatial navigation.
Another affected area was the anterior cingulate cortex, which helps regulate attention and emotions.
Together, these regions are closely linked to early Alzheimer’s disease.
Professor Barbara Sahakian, the study’s senior author from Cambridge University, explained the significance of these findings.
“The brain regions where we saw these differences are ones that tend to be affected by Alzheimer’s disease,” she said.
She added that menopause could make some women more vulnerable later in life.
“While not the whole story, it may help explain why we see almost twice as many cases of dementia in women than in men.”
The study also examined the impact of hormone replacement therapy.
Researchers found that HRT did not appear to prevent grey matter loss.
According to NHS guidelines, HRT can be considered for menopausal symptoms such as hot flushes and sleep problems.
However, the scientists said there remains a limited understanding of how menopause and HRT affect the brain, memory and mood.
The study noted that women using HRT were more likely to report poorer mental health.
Many of those women already experienced mental health difficulties before being prescribed the medication.
Co-researcher Dr Christelle Langley stressed the importance of recognising menopause as both a physical and emotional journey.
She said women face a wide range of struggles during this life stage.
“We all need to be more sensitive to not only the physical, but also the mental health of women during menopause,” she explained.
“There should be no embarrassment in letting others know what you’re going through and asking for help.”
The research also highlighted the role of white matter and grey matter in brain health.
Grey matter consists of neuronal cell bodies and their dendrites, which communicate with nearby neurons.
White matter is made up of long axons that transmit impulses to distant parts of the brain and spinal cord.
Both are essential for cognitive function and emotional regulation.
Michelle Dyson from the Alzheimer’s Society highlighted the wider impact of the findings.
She said women account for around two-thirds of people living with Alzheimer’s disease in the UK.
“While we still don’t fully understand why they are more susceptible than men, it is thought that hormones may play a role,” she explained.
She added that this large study strengthens evidence showing menopause can cause physical brain changes, including reduced brain volume.
However, she cautioned that the research cannot yet confirm whether these changes directly increase dementia risk.
Without long-term tracking of participants, scientists cannot know if the women later develop Alzheimer’s or other dementias.
For South Asian women, these findings may feel especially relevant, as conversations around menopause and mental health often remain taboo.
Many women already struggle silently with symptoms, balancing family responsibilities, careers and cultural expectations.
Experts stress that awareness, early support and open dialogue are crucial.
While menopause is a natural stage of life, researchers hope this study will encourage more personalised care and better long-term monitoring.
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