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

A new study from the University of Cambridge has found that menopause is linked to changes in the brain, along with higher levels of anxiety, depression, and sleep problems. The research, published in Psychological Medicine, also suggests that hormone replacement therapy (HRT) does not prevent most of these brain changes, although it may help slow down reaction-time decline.

Menopause usually occurs between the ages of 45 and 55, when hormone levels drop and periods stop. Many women experience hot flushes, low mood, poor sleep, and mental health challenges during this time. To better understand how menopause affects the brain, researchers analysed data from nearly 125,000 women in the UK Biobank.

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