Menopause also lowers the level of glucose in the brain, the primary fuel used by brain cells. For example, menopause can affect how brain cells are generated, connect with each other, and even die, and these processes impact brain regions that are critical for memory. Over the last 15 years, an increasing number of studies are mapping out the intricate ways in which menopause affects the brain and what helps maintain intact memory. All women eventually undergo menopause, but there is a large age range for when it begins (from late 40s to early 60s), and substantial variation in women's experience of its impact. Many women report increased forgetfulness and "brain fog" during the menopausal transition. However, women's advantage for verbal memory performance is reduced with menopause. On average, women perform better than men on measures of verbal memory, beginning as early as post-puberty. This is essential, because viewing brain aging as beginning in early midlife, and understanding the impact of menopause on the brain, will allow for development of strategies to prevent memory loss for women.
However, cognitive aging is rarely considered a women's health issue. Thus, women and men undergo different aging processes, especially in early midlife when reproductive aging is more critical for women than chronological aging. Our research team and others have demonstrated that estradiol directly relates to changes in memory performance and reorganization of our brain circuitry that regulates memory function. In addition to chronological aging, women undergo reproductive aging in early midlife: menopause, during which they experience a depletion over time of ovarian hormones such as estradiol, the primary form of estrogen that works in the brain. What happens to women's brains through the transition into menopause? However, understanding factors that happen earlier in life, and how they impact age-related brain changes, is critical for developing prevention strategies for one of the major public health challenges of our time. Most studies of aging and cognitive decline, particularly studies of AD, begin in people in their 70s. The decline in cognitive ability is not limited to neurodegenerative diseases like Alzheimer's disease (AD), but also part of healthy aging, with consequences for our quality of life. Preventing memory decline starts in early midlife Thus, maintaining intact memory starting early in midlife with the transition to menopause is critical not only for women themselves, but also for their families, society, and our economic health. Women are at the epicenter of this because the economic threat is especially dire for women, given they are an increasingly powerful element of our global economy and the vast majority of unpaid caregivers. The economic cost is staggering, as it is estimated to rise to more than $2 trillion. By 2050, 13.8 million people in the US will likely have Alzheimer's disease, and two-thirds will be women.
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