Every day in the US, an average of 6,000 women enter menopause.
Now, scientists from the University of Vermont’s College of Medicine have uncovered significant evidence of the neurological changes in the brain during this significant life stage, paving the way to finally understanding and ideally treating midlife cognitive decline.
“With decades of life remaining after menopause, it is important to understand the neurological effects of hormone changes at midlife,” says Abigail Testo, a postdoctoral research associate in the lab of study lead Julie Dumas. “Our research contributes to the growing body of work examining the relationship between menopause and the brain.”
Looking at scans of women’s brains in a “resting state” – when the brain isn’t actively engaged in specific tasks – the researchers uncovered a marked difference in women who had entered menopause, most likely due to the rapid shift in hormones.
“Differences in resting-state functional connectivity between the supramarginal gyrus, right anterior division, and right planum temporale at the connection level were identified between participants in the pre-, peri-, and postmenopausal groups when all groups were compared,” the researchers write.
“Further analysis comparing the pre- and postmenopausal groups revealed one cluster of altered resting-state connectivity that was lower in the postmenopausal group compared to the premenopausal group. Regions with altered connectivity included the left and right supramarginal gyrus, the anterior division, and the right and left planum temporale.”
Estrogen, perhaps not surprisingly, appears to play a large role here, with postmenopausal women losing 90-95% of the hormone’s supply. While studies in the last decade have tied it to cognitive function issues and emotional dysregulation, this research offers compelling evidence that the change has a profound impact on neuronal connectivity and critical brain communication pathways.
Despite somewhat of a shift, menopause has become slightly less of a taboo health topic, but stigma remains, as this 2022 study laid out.
Earlier this year, researchers from Monash University in Australia highlighted the debilitating effect of “brain fog” that many women (or people assigned female at birth) experience in midlife. Again, the team tied this to the rapid change in hormones.
“We don’t have any neuropsychological tests right now that are sensitive enough to detect brain fog per se, that could be rolled out easily in GP clinics,” Associate Professor Caroline Gurvich, clinical neuropsychologist and researcher at Monash University’s HER Centre Australia, said at the time.
“What we want GPs to do is consider factors that might be contributing to cognitive symptoms, such as sleep and mood, as well as conditions that may not be related to the hormonal changes of menopause, such as low iron and autoimmune conditions, that can be picked up through blood tests,” she added following the publication of their March 2026 paper in the journal Menopause.
Those researchers also highlighted how this lack of menopause-related cognitive impairment testing means women are left wondering: Is it dementia? Attention-deficit/hyperactivity disorder (ADHD), which is commonly diagnosed during perimenopause? Or a specific hormonal balance interrupting the brain’s normal programming, which could need an entirely different treatment approach?
This latest work from Dumas – associate director of the Clinical Neuroscience Research Unit and professor of psychiatry and Testo paves the way for clinical evidence of menopause’s impact on cognition.
It’s worth also remembering that women are disproportionately represented in age-related cognitive decline, especially Alzheimer’s disease (AD). According to the Alzheimer’s Association, nearly two-thirds of US adults living with AD are women. And the majority of this cohort are also post-menopausal women.
A 2026 study used established data that women face a one in five chance of developing AD by age 45. For Men, the chance is one in 10. As that paper noted, AD is often thought of as predominantly an “age-related” disease, which has seen less focus on how sex is a key risk factor.
While preliminary, these new findings build on a steadily growing body of evidence that the endocrine system is more influential in our brains than we might think. And it also provides mechanistic proof of structural brain changes that occur before, during, and after menopause.
It’s a small but meaningful step forward in our understanding of how menopause may advance brain aging – and one that could ultimately help researchers develop ways to fight cognitive decline.
After all, by 2050, more than 1.2 billion women around the world will be in or approaching menopause.
The study was published in the journal Menopause.
Source: University of Vermont College of Medicine via MedicalXpress
Fact-checked by Mike McRae
