Your Brain Starts Changing Years Before Menopause. Doctors Say You Can Steer It.
Women's Health
February 19, 2026
AI-Generated Deep Dive Summary
Menopause is linked to significant brain health changes that can begin years before symptoms like hot flashes or mood swings appear. A major new study finds that women going through menopause experience reductions in gray matter volume in key brain regions, including the hippocampus (memory), entorhinal cortex (information processing), and anterior cingulate cortex (emotional regulation and decision-making). These changes occur regardless of whether women use hormone replacement therapy (HRT) or not. While HRT can help manage some symptoms, it also showed unexpected links to higher anxiety levels in postmenopausal women.
The study, published in *Psychological Medicine*, analyzed data from nearly 125,000 women, including MRI brain scans of about 11,000 participants. It revealed that postmenopausal women, whether using HRT or not, were more likely to experience anxiety, depression, and sleep issues compared to premenopausal women. Notably, those who used HRT reported feeling more tired despite similar sleep durations, though the study couldn’t pinpoint why due to a lack of data on dosages.
Experts emphasize that while hormonal shifts likely play a role in these brain changes, lifestyle factors may offer some control over cognitive decline. Regular exercise and engaging in mentally stimulating activities like learning new skills have been shown to support brain health as women age. These findings are particularly important for women approaching menopause, as they highlight the need for proactive strategies to protect cognitive function.
This research underscores how critical it is to address brain health during menopause, a time when subtle but significant changes can impact mental clarity, emotional well-being, and overall quality of life. Understanding these changes early gives women the opportunity to take steps that could mitigate their effects and maintain cognitive sharpness as they age.
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Originally published on Women's Health on 2/19/2026