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Wednesday, August 4, 2021

We need to know how menopause changes women’s brains

During menopause, which marks the end of a woman’s menstrual cycle, her ovaries stop producing the hormones estrogen and progesterone, ending her natural childbearing years. But those hormones also control how the brain functions, and the brain controls their release—meaning that menopause is also a neurological process. “Many of the symptoms of menopause can’t possibly be produced directly by the ovaries, if you think about hot flashes, night sweats, anxiety, depression, insomnia, brain fog,” says Lisa Mosconi, an associate professor in the study. Director of Neurology and its Women’s Brain Initiative at Weill Cornell Medicine. “Those are symptoms of the brain, and we should look at the brain as something that is affected by menopause, at least as much as your ovaries.”

In June, Mosconi and his colleagues published one of the few studies to be examined in detail in the journal Scientific Reports. what happens to the brain during the menopausal transition, Not just before and after. Using various neuroimaging techniques, they scanned the brains of more than 160 women between the ages of 40 and 65 who were in various stages of transition to examine organ structure, blood flow, metabolism and function; He did several scans of the same type two years later. They also copied the brains of men of the same age group. “What we found in women and not in men is that the brain changes significantly,” Mosconi says. “The transition to menopause actually leads to a complete remodeling.”

On average, women in the United States enter the menopausal transition — defined as the first 12 consecutive months without a period — at around 50; Once diagnosed, they are in postmenopause. But at the age of 40, hormonal fluctuations can start in them. (For some women, this happens in their 30s, and surgical removal of the ovaries leads to immediate menopause, as do some cancer treatments.) Those fluctuations cause irregular periods and potentially hot flashes. There are a variety of symptoms including flashes, insomnia, mood swings. Trouble concentrating and changes in arousal. During this phase, known as perimenopause, which is an average of four years long (but can last from several months to a decade), Mosconi and her colleagues observed that their female subjects developed gray matter (brain cells). who process the information) and experienced the loss of both. White matter (the fibers that connect those cells). Postmenopause, however, that loss stopped, and in some cases the brain increased in volume, though not its premenopausal size. The researchers also explored how the brain metabolizes energy, but these did not affect performance on tests of memory, higher-order processing, and language. This suggests that the female brain “goes through this process, and it recovers,” said Jill M., professor of psychiatry and medicine at Harvard Medical School. Goldstein and founder and executive director of the Innovation Center on Sex Differences in Medicine at Massachusetts General. Hospital. “It’s adapting to a new normal.”

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