Severe Menopause Symptoms May Be Linked to Cognitive Decline—Here’s How to Protect Your Brain During This Time

If you’re going through menopause, you’re likely well aware of the physical changes this time of life can bring. As your estrogen hormone levels dip, your weight, mood, sleep patterns, and even your cognitive function can also wax and wane. While brain fog is typically the most commonly reported cognitive symptom, menopause and brain health issues may have an even deeper, and impactful, relationship.

New research published in Menopause¹, the journal of The Menopause Society, found a possible link between severe menopause symptoms (including hot flashes and depression) and cognitive function in postmenopausal people. The study’s authors say their findings may help illustrate the complicated relationship between hormonal, lifestyle, and other factors involved in brain health as we age.

Read on to learn more about the study findings, the relationships between menopause and brain health, and how to keep your brain in tip-top shape in menopause and beyond.

What this recent study found

In the study, researchers included nearly 1,300 late-postmenopausal people from nine Latin American countries. Each person received menopause treatment in private medical clinics and filled out several questionnaires, including something called the Menopause Rating Scale. After gathering the data, researchers found that 15.3 percent had mild cognitive impairment (e.g., memory and concentration issues). These people also reported more intense menopause symptoms—including hot flashes, sleep, and mood disturbances—compared to those who did not demonstrate cognitive impairment.

Previous medical research has explored temporary effects of estrogen loss on brain function during menopause and immediately post-menopause, says Lauren Streicher, MD, an OB/GYN and founder of the Northwestern Medicine Center for Sexual Medicine and Menopause. But this study stands out for exploring the possible longer-term effects, she adds. “The real question is: What do we know about cognitive function [during menopause] later on?”

Experts agree that not every menopausal person with hot flashes, sleep disruptions, mood swings, or even brain fog caused by estrogen dips will have dementia or other cognitive issues in the future. The new research simply highlights the possibility of an increased risk, not an exact cause. In other words, this research is an important, exploratory step as medical experts seek to better understand the connections between menopause, lifestyle choices, and brain health.

“Identifying this possible association between severe menopausal symptoms with cognitive impairment can and should be an incentive to continue in this line of research in search of alternatives that improve the health of menopausal women in all aspects,” Andrés Calle, MD, an OB/GYN, research director at Central University of Ecuador, and lead author of the Menopause study, stated in the study’s release.

5 ways to protect your brain during and after menopause

While the underlying mechanisms connecting menopause symptoms and cognitive function aren’t completely understood yet, there is some good news here. The Menopause study suggested there are plenty of ways to be proactive when it comes to maintaining brain fitness through menopause and beyond.

“All the stuff we talk about as being good for heart health is also good for brain health,” says Stephanie Faubion, MD, an OB/GYN, medical director of The Menopause Society, and director of the Mayo Clinic Center for Women’s Health. “Those same vessels that are important for your heart are important for your brain health. The dots are all connected here.”

That said, here are five changes you can make to your routine to nurture your brain and heart:

1. Make healthy lifestyle choices

It should come as little surprise that taking care of your body as a whole will help your brain, too. This includes eating more nutritious and wholesome foods, getting daily exercise, maintaining a healthy weight for your body size, and making sure things like your blood pressure and cholesterol levels are all within a healthy range—which can help keep your vasomotor system (i.e., a part of your nervous system that can lead to hot flashes in menopause when unbalanced) stable.

Additionally, if you smoke, try to quit to improve your overall health. And try to work toward reducing your alcohol intake: The average recommended amount is one drink per day or less, per the Centers for Disease Control and Prevention (CDC).

All of these self-care steps go a long way toward overall wellness—including improved brain function during menopause.

2. Lower your stress

For many, menopause can be a time of both personal and hormonal transitions. Caring for aging parents, launching children into adulthood, and tending to a career can all be overwhelming and lead to stress, anxiety, and burnout. Try to lower your mental load by practicing stress-relief techniques: This could include a mindfulness practice, meditation, or even a quick self-led yoga session. These activities are scientifically proven to be effective methods³² for mitigating the effects of stress.

3. Try and learn new things

The Menopause study authors found that learning new things is a protective factor when it comes to staving off post-menopausal cognitive issues. This goes beyond cracking open a book like you did in school. Staying curious and attuned to the world around you can offer brain boosts, too—especially for memory and concentration. In other words, “stimulate your brain and try new things,” says Dr. Faubion. This could include learning a new language or instrument, taking an art class, or starting another hobby you’ve always wanted to try.

4. Get good sleep

Sleep (both deep and REM) gives you a much-needed refresh each night. If you’re not getting enough restorative, quality snooze-time, you’re risking a whole host of potential neurological complications long-term—including dementia and cognitive decline. If your sleep hygiene routine needs help, now is the time to address it, for your brain’s sake. The recommendation is to get anywhere from 7 to 9 hours per night.

5. Try hormone therapy

Last but certainly not least, there is hormone therapy to consider—which is often supplemental estrogen that comes in the form of pills, patches, creams, or sprays. While the study in Menopause didn’t determine if treating hot flashes with hormone therapy could help improve cognition function later in life, experts say it’s well worth considering if symptoms are adversely affecting your day-to-day routine. “Treat those bothersome menopause symptoms,” says Dr. Faubion. “We hope that it will also help with brain health.”

While hormone therapy may not be ideal for everyone (i.e., people who’ve recently had breast cancer or those with a heart condition), ask your healthcare provider to see if it’s right for you.

When to see a healthcare provider

Cognitive decline can worsen as a result of menopause symptoms, although some people are simply more genetically predisposed to things like dementia or memory loss, regardless of menopause status. No matter what the root cause is, it’s worth bringing up issues like poor concentration, memory, or low mood to your healthcare provider, so you can be properly treated.

Also, menopause is a great time to take stock of your overall health and make certain adjustments if needed. Talk to your healthcare provider to discuss symptoms like hot flashes, review your blood work, and come up with a plan together that works for you and your health goals. And keep in mind: “Grinning and bearing it” through perimenopause—the precursor to menopause which can last years—isn’t necessary or advisable either now or for your future health, brain, or otherwise.

“So many women think that hot flashes and other menopause symptoms are unpleasant but harmless,” says Dr. Streicher. “We now have an enormous amount of data that shows it’s not just about quality of life, it’s about length of life, it’s about being functional whether we’re talking about cardiovascular disease or cognitive function.”