According to a study, early menopause is linked to faster mental decline

When a woman reaches menopause, it's not just how she feels, when her fertility ends and how quickly hormone production changes. The timing also affects the brain.

According to the long-term study published in the journal JAMA Network Open, earlier menopause was associated with faster mental decline and an earlier onset of Alzheimer's disease. To see what early menopause does to the brain in the long term, the researchers evaluated data from 2,603 ​​women.

At the start of the study, the participants were on average 78 years old. Most were observed for around seven years, some for up to 18 years. Repeated MRI examinations of the brain were also carried out on 778 women.

According to the researchers, the earlier the menopause began, the faster the women's mental decline. The researchers did not set a fixed limit for “early menopause”. They compared the respective ages at onset of menopause.

They were able to identify a special connection with episodic memory – i.e. the ability to remember past, personal experiences. The earlier women reached menopause, the faster this ability declined.

Women with earlier onset of menopause also received an Alzheimer's diagnosis earlier on average. According to the researchers' calculations, menopause ten years earlier corresponded to 1.8 years less without Alzheimer's disease.

But what did the MRI scans show? Women with an earlier onset of menopause developed changes in the white matter of the brain more quickly. This white substance consists of nerve fibers that connect brain regions. The images showed so-called hyperintensities: bright areas that occur more frequently with increasing age and can indicate damage to small blood vessels.

This was the strongest connection the researchers found in the MRI scans. If you follow their model calculation, a menopause five years earlier could be associated with around 15 percent more changes in the white matter of the brain after ten years.

A possible explanation is thought to be the changed hormonal balance during menopause. Because with menopause, the production of estrogen in particular decreases. It is precisely this hormone that influences, among other things, connections between nerve cells, metabolism and inflammatory processes in the brain.

The study cannot determine whether the earlier drop in hormones actually causes the later changes. Early menopause can also be a reflection of other aging processes such as sleep disorders or metabolic diseases, which influence both the timing of menopause and brain health.

The timing of menopause can therefore be seen as an early indication of later brain health. It is known before memory problems or changes in the brain become visible and can therefore help women with an increased risk to be monitored more specifically in middle age.