Midlife Crisis: The Effects of Menopause on the Brain and Ways to Protect It

Midlife crisis is known as a period of emotional turmoil, but new research suggests it is much more than that.
Menopause, occurring between ages 40 and 60, causes significant changes in the brain that can affect cognitive function and the risk of dementia.

Brain changes during menopause:

Structural changes:

• Changes in the hippocampus: An area of the brain vital for memory and learning. Imaging studies have shown a moderate decrease in gray matter volume in the hippocampus and entorhinal cortex during the hormonal transition, but an encouraging finding is that some of this decline stabilizes and even partially recovers in the postmenopausal stage.
• Decreased connectivity: Reduced connectivity between different brain regions, which may affect cognition and other brain functions.
  

Genetic changes:

• Increased expression of inflammation-related genes: Studies have found an increase in the expression of these genes in people during menopause, which may lead to chronic brain inflammation and impaired cognitive function.
• Decreased expression of genes involved in protein production at synapses: Synapses are the contact points between nerve cells, and these proteins are essential for their normal function. A decrease in their production may lead to impaired memory and cognition.

• Specific effects on women:
  • Higher levels of tau protein: Women tend to show higher levels and a faster accumulation rate of tau protein, especially in the presence of elevated amyloid levels and after menopause. These high levels are associated with a higher risk of Alzheimer's disease.

Tau protein:

Tau protein is a protein associated with microtubules, which form the skeleton of nerve cells. Its main role is to stabilize microtubules and assist in transporting substances along the axon. The accumulation of tau protein in pathological clumps in the brain is one of the main characteristics of Alzheimer's disease.

Ways to protect the brain:

• Dietary fiber intake: Studies have found a link between high fiber intake,
  (for an adult, a recommended dietary fiber intake of 25 grams to 30 grams per day (or 14 grams of fiber per 1000 kilocalories))
  and a reduced risk of dementia.
  
• Foods rich in dietary fiber:
  Fruits: Berries, apples, pears, citrus fruits.
  Vegetables: Broccoli, Brussels sprouts, carrots, sweet potatoes, green beans.
  Whole grains: Oats, brown rice, whole wheat bread, quinoa.
  Legumes: Lentils, beans, peas.
  Nuts and seeds: Almonds, walnuts, flaxseeds, pumpkin seeds.
  
• Physical activity: Regular physical activity (150 minutes per week) is associated with better brain health later in life.
  
• Dietary supplements:
  Phosphatidylserine: Among its other properties, it may protect the brain from damage caused by inflammation, neurodegenerative diseases, and other conditions.
  Ginkgo biloba: May improve memory, concentration, and cognitive ability, especially in older adults.
  Huperzine A: May improve memory, concentration, and cognitive ability, especially in older adults.
  Omega-3: May improve memory and prevent cognitive decline.
  

Additional healthy habits:

• Adequate sleep
• Balanced diet
• Stress management
• Avoiding smoking
• Moderate alcohol consumption

• Maintaining brain activity:
  • Reading
  • Solving puzzles
  • Learning new things
• Participating in social activities:
  • Strong social connections contribute to brain health.

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References:

https://www.neurology.org/doi/10.1212/WNL.0000000000011375
https://www.cell.com/cell/fulltext/S0092-8674(22)01124-2
https://pubmed.ncbi.nlm.nih.gov/37010830/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2733348/
https://www.medicalnewstoday.com/articles/reduction-in-hippocampus-in-brain-linked-to-cognitive-decline-risk
https://link.springer.com/article/10.1007/s00702-021-02451-8