Menopause Linked to Reduced Brain Volume and Higher Anxiety Symptoms, Study Finds

Women were grouped as pre-menopausal, post-menopausal without HRT, or post-menopausal with HRT. Some participants completed memory and reaction-time tests, and around 11,000 also had brain scans.

The study found that post-menopausal women were more likely to report anxiety, depression, insomnia, and fatigue. Those on HRT reported feeling the most tired, even though they slept about the same amount as other women. Importantly, higher anxiety and depression in the HRT group were already present before menopause.

Brain scans showed reduced grey matter in key areas involved in memory, emotions, and decision-making, including regions linked to Alzheimer’s disease. These changes were seen in post-menopausal women regardless of HRT use.

While HRT did not protect brain structure or mood, it helped slow the decline in reaction speed. The researchers stress the importance of supporting women’s mental health during menopause and maintaining a healthy lifestyle through exercise and balanced nutrition.

REFERENCE: Zühlsdorff, K., et al. (2026) Emotional and cognitive effects of menopause and hormone replacement therapy. Psychological Medicine. DOI: 10.1017/S0033291725102845. https://www.cambridge.org/core/journals/psychological-medicine/article/emotional-and-cognitive-effects-of-menopause-and-hormone-replacement-therapy/E9D94A6EB0B8A3C03113A93D34A99FD0