Menopause Brain: It's Real, Let's Talk About What You Can Do About It

Let’s talk about menopause and the brain. Yes, the brain! While we’ve spent decades blaming our ovaries for the hot flashes and mood swings, it turns out our brains are running the show. Spoiler alert: menopause is as much about neurons as it is about hormones. 

The Brain-Ovary Connection: It’s Complicated

Picture your brain and ovaries as two BFFs constantly texting each other through something called the hypothalamic-pituitary-gonadal (HPG) axis. This relationship keeps your hormones in check, managing everything from your mood to your memory.

But when menopause starts creeping in, estrogen levels dip, and this duo starts to ghost each other. Cue the hot flashes, anxiety, and the dreaded brain fog that makes you wonder if your keys are in the fridge.

Estrogen: Your Brain’s Rocket Fuel

Estrogen, particularly estradiol, isn’t just about making babies. It’s like rocket fuel for your brain, powering your neurons and keeping them sharp. When estrogen levels drop, your brain energy takes a nosedive.

Think of it like your neurons hitting the snooze button, suddenly, even simple tasks feel like solving a Rubik’s Cube blindfolded. Researchers have found that this energy slump is a menopause thing, not an age thing, so don’t blame the candles on your last birthday cake.

Menopause & Memory

Ever walked into a room and instantly forgotten why? It’s not just you. About 40% to 60% of women experience cognitive complaints during menopause. This includes brain fog, forgetfulness, and occasionally losing your train of thought mid-sentence.

The good news? Your brain isn’t broken; it’s just adapting to hormonal changes. Think of it as a renovation project, it might be messy now, but there’s potential for a fresh start.

Lifestyle Hacks for a Brainy Menopause

• Start with your diet. 
  
  A plant-based diet is basically a love letter to your brain. Load up on fruits, veggies, whole grains, and plant-based protein like tofu and pea protein. Bonus points for phytoestrogens (hello, flaxseeds and soy), which act like mini-estrogens to help smooth out the transition.
  
  Fiber from fruits and veggies supports gut health, which has a direct connection to brain health through the gut-brain axis. A healthy gut microbiome can reduce inflammation and support the production of neurotransmitters like serotonin. It also promotes better blood sugar regulation, preventing cognitive impairments associated with insulin resistance.
  
  See our Nutrition Guide for Good Sex & Health for more helpful information.
  
  
• Stress? No thanks.
  
  Chronic stress can deplete estrogen levels faster than a toddler eats Goldfish crackers. Try yoga, meditation, or even an impromptu dance party in your kitchen. Go ahead, get wild, your brain will love it.
  
  
• And don’t forget to move.
  
  Physical activity boosts brain health, so aim for at least 150 minutes of moderate exercise per week. 

HRT: The Brain Health Ally You Didn’t Know You Needed

Hormone replacement therapy (HRT) isn’t just about ditching hot flashes. It’s like giving your brain a spa day. By replenishing estrogen, HRT can reduce brain fog, mood swings, and memory lapses. It might even lower your risk of cognitive decline and Alzheimer’s. 

Let’s talk about estradiol (estrogen patches), the chill MVPs of the HRT world. Unlike estrogen pills that drag your liver into the drama, these little patches deliver hormones directly through your skin. They keep things smooth, steady, and way less risky when it comes to big-deal stuff like blood clots.

Still side-eyeing HRT because of the risks? Grab your comfiest blanket, pour some tea, and let’s tackle those worries head-on. Turns out, if you start hormone therapy before you hit 60 or within 10 years of menopause, it actually lowers the risks you’ve been sweating over. That’s not just me saying it—this comes straight from this compelling study at the American Heart Association.

Here’s the tea:

• Cardiovascular disease? Reduced.
• All-cause mortality (aka avoiding untimely exits)? Lowered.
• Certain cancers? Yup, less risk there too.

And the estrogen patches? They’re the gift that keeps on giving. Pair them with micronized progesterone (if you’re not already taking it orally, which is more ideal), and you’ve got a dynamic duo that keeps hormone levels steady, your heart happy, and your mood from pulling a rollercoaster move.

So, here’s the bottom line: HRT isn’t the scary, shadowy figure it might seem. It’s more like your cool, science-backed BFF who just wants you to feel like yourself again, hot flashes be damned.

Why Oral Progesterone Could Be Your Brain’s BFF

When it comes to brain health, oral progesterone is like a personal assistant that smooths the way, ensuring everything stays balanced and functioning. Here’s the deal: progesterone isn’t just about hormones—it’s also a brain booster. When taken orally, progesterone gets metabolized into a magical compound called allopregnanolone (yes, it’s a mouthful, but stay with me).

Allopregnanolone doesn’t just sound fancy; it’s like the brain’s natural spa day. It calms things down, reduces anxiety, and even helps protect neurons from stress. Think of it as giving your brain a cozy blanket and a cup of tea when life gets overwhelming.

Oral progesterone also plays a role in supporting memory and cognition. It’s like the little engine that could, helping keep your brain sharp and resilient as you age. Studies suggest that this type of progesterone may even have protective effects against neurodegenerative diseases. So if you’re trying to hold onto the ability to remember where you hid the snacks from yourself, it’s worth considering.

And let’s talk sleep, because what’s good for your brain is also good for your Zzzs. Oral progesterone is the brain’s bedtime whisperer, encouraging restful, rejuvenating sleep. A well-rested brain is a healthier brain, capable of handling everything from making major decisions to not snapping at your family when someone forgets to change the toilet paper roll (again).

Supplements can be helpful, but they don’t provide the same brain-boosting benefits as oral progesterone. Transdermal progesterone (like the kind included with estradiol patches) bypasses the process that creates allopregnanolone—a compound that protects and supports your brain—so you miss out on those extra brain health benefits.

The takeaway? Oral progesterone isn’t just about balancing hormones—it’s about keeping your brain happy, healthy, and ready to crush life’s challenges. So if you’re looking for an option that benefits both body and mind, this might just be the star player in your hormone lineup. A nightly progesterone pill can make a world of difference for your sleep and mental health!

Creatine: Not Just for Gym Bros

Bet you didn’t see this one coming, creatine isn’t just for bulking up at the gym. It’s also a sneaky brain booster. Studies show it can help you think faster, remember better, and even improve your mood.

If you’re feeling foggy or forgetful, creatine might just be your new secret weapon. Plus, it’s safe for most people in moderate doses. As always, check with your healthcare provider before diving in, especially if you’re already juggling a pile of supplements.

Benefits of Phosphatidylserine

1. Cognitive Support: Research suggests that PS may help with memory, attention, and executive functioning, which can be particularly beneficial for individuals experiencing cognitive decline or menopause-related brain fog.
   
   
2. Stress Reduction: PS has been studied for its ability to lower cortisol levels, the stress hormone. Since menopause can increase stress susceptibility, PS might provide some relief.
   
   
3. Neuroprotection: PS supports brain cell membrane integrity and function, which could be helpful in counteracting some age-related cognitive changes.

Evidence for Use in Menopause

While PS is not specifically studied for menopause-related brain fog, its general cognitive benefits might make it worth considering as part of a broader approach to menopausal brain health. Combining PS with other interventions, like maintaining a healthy diet, engaging in regular physical activity, ensuring quality sleep, and managing stress, can enhance its effects.

Dosage and Safety

• The typical dose for cognitive benefits is 100–300 mg per day, often divided into two or three doses.
  
  
• PS is generally well-tolerated, but some individuals may experience mild side effects, like stomach upset or insomnia, especially if taken in the evening.

Brain-Boosting Nutrients

Certain nutrients can work wonders for brain health during menopause.

• Omega-3 Fatty Acids (DHA & EPA): Found in fish oil or algae-based supplements, they support brain cell membranes and improve mood.
  
  
• B Vitamins (B6, B9, B12): Vital for neurotransmitter function and reducing cognitive decline.
  
  
• Vitamin D: Helps regulate mood and supports neurogenesis.
  
  
• Magnesium: Enhances memory, learning, and sleep quality.
  
  
• Choline (Alpha-GPC or CDP-Choline): Supports memory and learning by boosting acetylcholine.
  
  
• Coenzyme Q10 (CoQ10): An antioxidant that energizes brain cells.
  
  
• Acetyl-L-Carnitine (ALCAR): Supports focus, mood, and mitochondrial function.

Antioxidants for a Sharper Brain

Antioxidants protect brain cells from oxidative stress and inflammation.

• Vitamin E: Supports memory and brain health.
  
  
• Alpha-Lipoic Acid (ALA): Protects brain cells and promotes mitochondrial health.
  
  
• Curcumin (from Turmeric): Crosses the blood-brain barrier to improve memory and mood.
  
  
• Resveratrol: Found in red wine and plants, it boosts blood flow to the brain.

Sleep and Stress Support

Menopause can wreak havoc on your sleep, but a few supplements might help.

• Ashwagandha: Reduces cortisol levels and supports brain function under stress.
  
  
• L-Theanine: Found in green tea, it promotes relaxation and focus.

The Bigger Picture: Menopause and the Female Brain

Dr. Lisa Mosconi, a neuroscientist and total rockstar in women’s brain health, has pointed out how underfunded and underresearched this area is. She’s leading the charge in uncovering why menopause makes women more vulnerable to Alzheimer’s and how we can change the narrative.

The bottom line? Understanding the female brain isn’t just important; it’s crucial for better care and treatment.

Embrace Your Brain Power!

Menopause is the time to focus on you, whether that means trying HRT, adding brain-boosting foods to your plate, or finally cracking open that mindfulness app you downloaded three years ago.

Remember, menopause isn’t about surviving—it’s about thriving. You’re not just dealing with hot flashes and brain fog; you’re preventing fall risks and dementia in your future and you are worth fighting for!

 

For more helpful information see more of our menopause guides:

HRT & Strength Building: Why Women Need to Rethink Aging

Perimenopause & Menopause Solutions