Menopause marks a key transition in women’s lives, as hormone levels decline and menstruation stops, typically affecting women aged 45 to 55. It is often accompanied by hot flushes, low mood and sleep problems, and previous research has linked menopause to cognitive decline, such as memory, attention and language deficits.
Hormone replacement therapy (HRT) is sometimes prescribed to counter the effects of menopause, particularly depressive symptoms and sleep problems. While menopause is inevitable and HRT is considered the most effective treatment available, relatively little is known about how either impacts the brain, cognition and mental health, SciTechDaily reports.
Researchers from the University of Cambridge sought to answer these questions, analysing data from the UK Biobank of nearly 125,000 women, divided into three categories: pre-menopausal women, post-menopausal women who have never used HRT, and post-menopausal women who have.
Their findings suggest that while HRT does not appear to mitigate loss of the brain’s grey matter, anxiety, depression, or difficulties sleeping, it does help slow the decline of reaction times.
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Among participants, the average onset of menopause was around 49.5 years old with HRT treatments starting at around 49 years old. Using questionnaires, cognition tests and MRI scans, researchers were able to tease out trends among the three groups.
Post-menopausal women were more likely to seek medical help for anxiety, nerves or depression, and scored higher on questionnaires for symptoms of depression than their pre-menopausal counterparts. A pattern of greater anxiety and depression among those in the HRT group turned out to reflect differences in symptoms prior to menopause, possibly indicating that doctors prescribed HRT in anticipation of symptoms worsening.
The post-menopausal groups were more likely to report insomnia, sleeping less and feeling tired, with those on HRT the most tired of all groups, despite no difference in sleep duration between them and the other post-menopausal group. In terms of cognition, there was no significant difference in memory tasks between the three groups, although post-menopausal women not on HRT had slower reaction times.
Significant reductions in grey matter among post-menopausal groups were concentrated in areas of the brain that tend to be affected by Alzheimer’s, which the authors speculate could help explain why we see nearly twice as many cases in women than in men.
