Menopause, Estrogen and the Brain

Sex hormones like estrogen and testosterone don’t just race around the body, helping to facilitate reproductive behaviors.  We now know that the brain is full of receptors for these sex steroids, and that these hormones act on brain cells both as a mediator–helping other chemicals do their work in the synapse–and through direct action on their own.  Estrogen and testosterone may act as neurotransmitters in their own right and work signaling magic in the cortex.  As such, they influence human cognition and behavior.

But understanding how these chemicals are doing this is outrageously complicated, says Paul Micevych, a a molecular biologist from the University of California, Los Angeles, who studies how estradiol, a form of estrogen, works in the brain.  While our conversation was about how important estradiol signaling is when it comes to love and sex related behaviors (chronicled in Dirty Minds), he also mentioned menopause.

“It’s not that the female brain can’t function without estradiol.  Women, after menopause, are a clear example of the fact that women can function very well without estradiol,” he told me.  “But during menopause, when you start to lose that estradiol, the brain struggles.  It’s just lost a chemical that it’s been dependent on.  And now it has to function without that support–resulting in changes to emotional response, to hot flashes, to memory loss.  The brain is fine afterwards but, with menopause and that loss of estradiol, it takes a while for the brain to reset.”

That conversation came back to mind when I read about a study recently completed at the University of Illinois at Chicago that shows that menopause “fog” is real–and likely isn’t just the result of normal age-related cognitive decline.

Pauline Maki, director of Women’s Mental Health Research in the department of psychiatry at University of Illinois at Chicago, and colleagues followed 75 women in perimenopause, documenting their hormone levels, cognitive skills, mood and overall health.  They also asked them to rate how serious they thought their memory loss was–and 41% of participants said their memory problems were serious.

The interesting thing here?  Individuals in age-related cognitive decline do *not* report that their memory loss is a problem.  The fact that these women recognized it was telling.

The group found results that suggest menopause “fog” is not due to poor mood, hot flashes or poor sleep.  Rather, fluctuating estrogen, influencing parts of the brain involved with memory, was the culprit.  Yet, the researchers did not find an association between lower estrogen (when measured in the blood) and memory ability.

As Micevych said, understanding this critical signaling is complicated.  But the good news, for both Maki’s subjects and the rest of us women, is that the brain will eventually reset.  Until science advances to give us a better understanding of how estrogen is influencing memory during the great change of life, us girls will just have to muddle through it. 

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