- Menopause marks the end of reproductive life and is diagnosed after 12 months of no menstrual period.
- New research suggests that menopause can significantly reshape the brain, and a non-hormonal drug called fezolinetant is being developed to treat hot flashes.
- Perimenopause, characterized by irregular hormone patterns, can cause circuits in the brain that rely on estrogen signalling to struggle, leading to symptoms like hot flashes, anxiety, and “brain fog.”
Menopause is a natural biological process that all women go through as they age. It marks the end of reproductive life and is typically diagnosed when a woman has not had a menstrual period for 12 consecutive months.
While the symptoms of menopause are widely discussed and researched, less attention has been given to how menopause affects the brain.
New research from the University of Arizona suggests that menopause can significantly reshape the brain. Naomi Rance, a neuropathologist at the University of Arizona in Tucson, started studying menopause and the brain, and the results shocked her.
“This was changing so much in postmenopausal women, it had to be important.” Rance discovered a way to study menopause symptoms in rats through tiny temperature changes in their tails. This helped her measure hot flashes, a common symptom of menopause that is thought to be triggered in the hypothalamus.
Based on her study, the US Food and Drug Administration is working on a drug called fezolinetant, if approved, this drug will be a historic achievement, and the first non-hormonal therapy to treat the source of hot flushes, which almost 80% of women feel as a side-effect through the transition.
Menopause & Its Impact on a Woman
We think of menopause as being driven by changes in the ovary,” shared Hadine Joffe, who studies mental health and ageing in women at Harvard Medical School in Boston, Massachusetts. “The notion of the brain at the helm of menopause is a different concept.”
Menopause typically occurs between the ages of 45 and 55, and menstrual bleeding ceases for at least 12 consecutive months. However, the decline in ovarian function associated with menopause is not an immediate occurrence.
Instead, women may undergo years of uneven ovarian function, resulting in inconsistent production of important sex hormones such as estrogen and progesterone.
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According to Ami Raval, a specialist in reproduction and neurology at the University of Miami in Florida, this process is not sudden but rather a slow and gradual decline. The ovary sends signals over time that it’s time to shut down its physiological functions.
The years leading up to menopause, known as perimenopause, can be characterized by irregular hormone patterns. This can cause circuits in the brain that rely on estrogen signalling to struggle, according to Roberta Brinton, a neurobiologist at the University of Arizona.
Oestrogen has many benefits for the brain, including the stimulation of glucose uptake and energy production. During perimenopause, hormone levels may suddenly drop one week, only to rise again the next, causing a period of neuronal disharmony.
Symptoms during perimenopause include hot flashes, irregular periods, anxiety, high blood pressure, and concentration difficulties known as “brain fog.” Addressing these symptoms during perimenopause could potentially slow the progression of age-related diseases such as Alzheimer’s and stroke.
However, there is no clear start or end to perimenopause, making it challenging to study. Treatment options for perimenopausal symptoms are limited, leading some women to try unproven remedies like herbal supplements.
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Debunking Myths & Taboos
Kathryn Schubert, president of the Society for Women’s Health Research in Washington DC, shares that an important conversation has started amongst both men and women in regard to menopause. This is a very important contributor towards breaking taboos and will help build more awareness in order to debunk myths.
Pharmaceutical and consumer-health firms are also working to raise awareness. During perimenopause, circuits in the brain that previously relied on oestrogen signalling can be left floundering, says Roberta Brinton, a neurobiologist at the University of Arizona in Tucson.
Oestrogen does a lot for the brain: it stimulates glucose uptake and energy production. Once the transition to menopause is complete, neurons grow accustomed to its absence. But in the perimenopausal period, levels of the hormone can crash one week only to soar the next.
The result can be a period of neuronal discord in which brain cells are periodically deprived of oestrogen, but not for long enough to forge the pathways needed to adapt to life without it, says Brinton.
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