Red Alert!! Women's brains shrink during perimenopause!!

Art depicting the human brain

Hey folks, has anyone stumbled upon this mind-blowing podcast channel on YouTube called The Diary of a CEO? It's like a treasure chest of wisdom!

They recently had a chat with "The Menopause Doctor," and let me tell you, it was so jam-packed with info that I'm going to split it into two posts just to do it justice. Stay tuned for the menopause magic!

Meet Dr. Mosconi, the Menopause Maestro! She’s a researcher at Weill Cornell Medical School who’s on a mission to crack the code of what happens to women during the wild ride of perimenopause.

Her detective work dives into the female brain’s rollercoaster during this hormonal hoopla. Spoiler alert, our brain structure and volume actually change during perimenopause. She’s also on the hunt to figure out how these brain changes might be sneaking in an extra risk for Alzheimer’s disease.

So, let’s give a big round of applause to Dr. Mosconi for being a trailblazer in the perimenopause business! Here’s a link to her treasure trove of publications on the topic.

Renovating The Brain During Perimenopause And Beyond

Dr. Mosconi refers to many of the changes that occur during perimenopause as the “Renovation of the brain”. So hold onto your hats, because hormones mess with your brain BIG TIME!

If you've ever wandered into a room and instantly forgot why you're there, welcome to the brain fog club! Dr. Mosconi actually led the first study that correlates physical changes in brain structure with the brain fog experienced during perimenopause. This is huge for women! I mean it sucks for us in reality but it explains A LOT.

She tells a story of how she started making important connections between hormones and brain function. In one of her early studies, a woman that volunteered for one of her research studies, was having major hot flashes while she was asked to complete certain tasks. Well Dr. Mosconi was able to figure out that during hot flashes, women literally can’t think straight and the volunteer couldn’t complete the tests because she could not concentrate.

Is there a link between perimenopause and dementia?

Dr. Mosconi's studies revealed that women that are perimenapausal, compared to men of the same age group, have increased plaque formation in the brain. Ok, so what are plaques? Plaques are like those pesky proteins throwing a wild party in your brain cells (aka neurons). Imagine them as tiny troublemakers jamming up the works, so your neurons are too busy dealing with the chaos to do their jobs right. The big takeaway? These party-crashing plaques are linked to dementia, including the infamous Alzheimer's disease.

And menopausal woman had even more plaques than age-matched men. This is REALLY intriguing! It seems like men drew the short straw when it comes to motorneuron diseases like Parkinson's and ALS, where neurons decide they've had enough of controlling muscle contractions. Meanwhile, women are more likely to get the backstage pass to Alzheimer's disease. It's like a bizarre health lottery where no one really wins! And it looks like, based on her research, hormones might be the culprit when it comes to women's increased risk for Alzheimer's disease.

Ok so how do hormones actually impact the brain? The neuroendocrine system essentially connects the brain to the ovaries. The endocrine system secretes hormones and neurons can respond to those hormones. What kind of things does the neuroendocrine system regulate?

• Metabolism, growth, and reproduction 

• Stress response 

• Blood pressure and heart rate 

• Air and blood flow through the lungs 

• Sugar (glucose) in the blood 

• Bone and muscle growth and development 

• Mood, sleep, and thermoregulation

This system flips the switch when puberty hits. Picture that hormonal teen in your life—a real rollercoaster, right? It's also on hyperdrive during pregnancy, like it's had too much caffeine. But as you cruise into perimenopause, it starts to take a nap and by menopause, it's out cold! It’s also partially shut down after pregnancy. And that flux in your hormones can cause postpartum depression and anxiety.

Estrogen is in ways the most important hormone for women and it can be considered the "master regulator " of female brain function. For example, there’s more blood flow to the brain with higher estrogen. But it’s also a "growth hormone" so it is important for neuroplasticity, which allows the brain to adapt to change, create new neural connections and neural pathways!

It gives brain cells a sugar rush, turning glucose into energy, because the brain is an energy hog! So, when estrogen takes a nosedive, it's no wonder we suddenly can't remember where we left our keys or what we walked into a room for. In fact, brain activity drops by about 30% from premenopause to postmenopause, like going from a high-speed internet connection to dial-up!

And those hot flashes? Body temperature regulation is controlled by the hypothalamus. Those pesky hormone fluctuations really mess with the hypothalamus and cause hot flashes.

Menopause also affects the volume, blood flow and electrical conductivity of the brain. I know, it sounds like a doomsday list of events. But don't be too alarmed because some women do not show any brain changes but others are not so lucky and show very severe changes. So how many people actually experience this?

Brain fog or mental exhaustion is experienced by 62% of perimenopausal women.

This can manifest as issues with focus, attention and language – where you have a word at the tip of the tongue but just can’t come up with it. I personally am really feeling the tip of the tongue syndrome and it drives me crazy since I do a lot of public speaking.

Then there is also "Subjective Cognitive Decline" This is where you are aware of this cognitive decline but you would pass a standard cognitive test. Unfortunately in the medical field professionals STILL say it’s just that women are crazy. But dismissing the changes of women’s brains and challenges they face is just not ok! There is actually remodeling happening in the brain. But ob/gyns aren’t trained to deal with neurological things so there need to be brain specialists/neurologists involved in the future.

The great news is that once you hit late postmenopause, that pesky brain fog starts to clear up. But for some women, it seems their memory decides to take a permanent vacation... still waiting for that postcard!

I'll be digging deeper into Dr. Mosconi's work AND spilling the beans on hormone replacement therapy soon.

So keep your eyes peeled and maybe even join our mailing list to get the latest blog gossip straight to your inbox!