Many women going through menopause report experiencing “brain fog,” a feeling of mental fatigue, forgetfulness, and trouble focusing.
This can be frustrating and confusing, especially when women still appear healthy and capable in other ways. Scientists believe this brain fog may be linked to changes in hormone levels, especially estrogen, during the menopause transition.
A new research review has pulled together findings from several studies to better understand how menopause affects the structure of the brain and how this might relate to changes in memory, mood, and thinking.
This review was presented at the 2025 Annual Meeting of The Menopause Society in Orlando. It shows that menopause can bring real, measurable changes in the brain. Researchers have found that gray matter—the part of the brain involved in memory and decision-making—can shrink in key areas like the hippocampus and the frontal and temporal lobes.
These parts of the brain help us remember things and make choices. When gray matter volume drops, women may notice issues with memory, especially verbal memory and spatial thinking.
Other studies found that women going through menopause may have more white matter hyperintensities. These are bright spots that show up on MRI scans and may be signs of tiny damage in brain tissue.
Women who go through menopause early or who have frequent hot flashes are more likely to have these white matter changes. These spots can be linked to problems with thinking, balance, mood, and even a higher risk of stroke and dementia.
There is some good news too. Some studies suggest that after menopause, gray matter volume may begin to recover. This might mean that the brain is able to adapt, or “re-wire” itself, in a process called neuroplasticity.
Scientists have also seen that during menopause, the brain shows more estrogen receptors. This could be the brain’s way of trying to adjust to lower hormone levels. However, more receptors aren’t always a good thing—some research links this increase to weaker memory in certain cases.
Menopause also affects how blood flows in the brain and how the brain uses energy. These changes are further signs that menopause has a strong effect on brain health.
This review was done by PhD psychology students Angélica Rodríguez and Andrea Pereira at the BRAVE Lab of Ponce Health Sciences University in Puerto Rico. Their project was supervised by Dr. Bárbara Barros and Dr. Karla Martínez.
The findings was shared at the 2025 Annual Meeting of The Menopause Society in a poster titled “Menopause and Brain Structural Changes: A bibliographic revision.” Rodríguez, the first author, will present the poster.
Rodríguez says this work shows how important it is to keep studying the link between menopause and the brain, especially how it affects memory, mood, and daily functioning. Dr. Stephanie Faubion, the medical director of The Menopause Society, agrees.
She says this type of research helps build a better understanding of why women experience brain fog during menopause. The goal is to find new and better treatments that can help women stay sharp and feel better during this stage of life.
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The study is published in Menopause.
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