Menopause linked to loss of grey matter in the brain, poorer mental health and sleep disturbance with and without hormone replacement therapy

Bad news! Or what is the influence of pre-existing conditions?

"The study ... found that hormone replacement therapy (HRT) does not appear to mitigate these effects, though it can slow the decline in reaction times. ...

The average age of onset of menopause among the participants was around 49.5 years, while the average age that women prescribed HRT began their treatment was around 49 years.

Post-menopausal women were more likely than those pre-menopause to have sought help from their GP or a psychiatrist for anxiety, nerves or depression, and to score more highly on questionnaires for symptoms of depression. Similarly, they were more likely to have been prescribed antidepressants. ...

further analysis showed that these differences in symptoms were already present before menopause. ...

Women post-menopause were more likely to report insomnia, get less sleep, and feel tired. Those on HRT reported feeling the most tired of all three groups ..."

From the abstract:

"Abstract

Background

Menopause is a natural physiological process, but its effects on the brain remain poorly understood. In England, approximately 15% of women use hormone-replacement therapy (HRT) to manage menopausal symptoms. However, the psychological benefits of HRT are not well established. This study aims to investigate the impact of menopause and HRT on mental health, cognitive function, and brain structure.

Methods

We analyzed data from nearly 125,000 participants in the UK Biobank to assess associations between menopause, HRT use, and outcomes related to mental health, cognition, and brain morphology. Specifically, we focused on gray matter volumes in the medial temporal lobe (MTL) and anterior cingulate cortex (ACC).

Results

Menopause was associated with increased levels of anxiety, depression, and sleep difficulties. Women using HRT reported greater mental health challenges than post-menopausal women not using HRT. Post-hoc analyses revealed that women prescribed HRT had higher levels of pre-existing mental health symptoms. In terms of brain structure, MTL and ACC volumes were smaller in post-menopausal women compared to pre-menopausal women, with the lowest volumes observed in the HRT group.

Conclusions

Our findings suggest that menopause is linked to adverse mental health outcomes and reductions in gray matter volume in key brain regions. The use of HRT does not appear to mitigate these effects and may be associated with more pronounced mental health challenges, potentially due to underlying baseline differences. These results have important implications for understanding the neurobiological effects of HRT and highlighting the unmet need for addressing mental health problems during menopause."

Menopause linked to loss of grey matter in the brain, poorer mental health and sleep disturbance | University of Cambridge "Menopause is linked to reductions in grey matter volume in key brain regions as well as increased levels of anxiety and depression and difficulties with sleep, according to new research from the University of Cambridge."

Emotional and cognitive effects of menopause and hormone replacement therapy (open access)