Scans Reveal Changes in Brain's Estrogen Activity During Menopause
According to a new brain imaging study led by researchers at Weill Cornell Medicine, the transition to menopause is marked by a progressively higher density of estrogen receptors (ER) on brain cells, a measure that remains elevated in women up to their mid-sixties.
The findings were published in the journal Scientific Reports.
A central feature of menopause is the decline in the body’s production of estrogen. This leads to various bodily changes including the cessation of menstruation, but also to neuropsychiatric effects such as “brain fog,” depression, and anxiety.
In the study, the researchers scanned the brains of 54 healthy women aged 40-65 using PET with a tracer that binds to ERs. These receptors are found in multiple areas of the brain, especially in women, and mediate the many cognitive and behavioral effects of the female sex hormone estradiol, the most potent form of estrogen.
Scans comparing women at different menopausal stages revealed progressively higher ER density in several estrogen-regulated brain networks in the postmenopausal and perimenopausal groups compared to premenopausal controls.
Researchers interpreted this as a compensatory response to lowering levels of available estrogen— as estrogen levels drop during the menopause transition, the cells express additional receptors to sop up as much estrogen as possible.
The analyses also found that high ER density in some of these regions was associated not only with menopause status but also with patients’ reports of menopause-related cognitive and mood symptoms.
The results suggested that this technique may be a valuable tool for studying the brain effects of menopause and estrogen therapy.
“Using this method, we were able, for the first time, to measure ER activity in the brain, and to identify potential predictors of some of these common symptoms of menopause,” said study lead author Dr Lisa Mosconi.
The researchers further plan to use ER-PET imaging to study the long-term consequences of estrogen level changes in the brain—including persistently low levels after menopause, and rising levels with estrogen therapy.]
Reference: Mosconi, L., Nerattini, M., Matthews, D.C. et al. In vivo brain estrogen receptor density by neuroendocrine aging and relationships with cognition and symptomatology. Sci Rep 14, 12680 (2024). https://doi.org/10.1038/s41598-024-62820-7
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