What Happens to a Woman’s Brain During Menopause?

So, what does happens to a woman’s brain during menopause and why don’t we talk about these changes and how they impact us?

I recently began reading The Menopause Brain by Dr. Lisa Mosconi, a neuroscientist renowned for her work in women’s health. Her opening chapter resonated deeply—not because it was filled with shocking statistics (though it was), but because it spoke to something far deeper. It echoed what I’ve felt in my own journey through menopause and what I hear so often from the client’s I work with: a sense of invisibility, confusion, and frustration in a society that misunderstands and marginalises this pivotal life stage.

Despite making up half of the population, women are routinely left in the dark about menopause. It’s treated not as a natural transition, but as a disease and the beginning of the end—of youth, vitality, and even value. women are expected to endure symptoms silently, lest  they are labelled emotional, unstable, or “past their prime.” Many women don’t have support networks to share their experiences or just to let off steam.

The dominant medical narrative seems to reduce menopause to a few physical symptoms—hot flushes, breast changes, irregular periods—while largely ignoring its neurological dimension. Many general practitioners, through no fault of their own, receive minimal training in menopause care. As a result, women experiencing anxiety, insomnia, depression, or brain fog are often handed antidepressants instead of informed support.

Dr. Mosconi’s work is groundbreaking because it connects the dots between hormonal shifts and brain health. Her research reveals that menopause is not just a hormonal event—it’s a neurologically active process starting before or during perimenopause. In fact, brain energy levels can drop by as much as 30% during this transition, affecting everything from temperature regulation and sleep to mood and memory. This isn’t in our heads—it is our heads.

Her Women’s Brain Initiative, launched in 2017, was the first of its kind to image the female brain through menopause. What it found was astonishing: brain structure, chemistry, and connectivity all undergo profound shifts during perimenopause. It’s no wonder many experts now refer to it as a “second puberty.” These are not trivial changes—they are real, measurable, and they deserve recognition, research, and respect.

To understand how we got here, we must look back. The roots of our societal views of menopause go back in time. Charles Darwin once declared that men attain “a higher eminence, in whatever he takes up, than can women,” suggesting inherent female inferiority. Early 19th-century scientists twisted skull measurements to “prove” women’s lesser intelligence. Menopause, dubbed “women’s hell,” was treated with everything from water jets and vibrating devices to morphine, opium, and even lead-based injections. If none of that worked, women were often institutionalized.

By 1934, oestrogen had been discovered, but it was framed not as a support for wellbeing, but to preserve youth and attractiveness. The medical view shifted to seeing menopause as a disease of oestrogen deficiency. In 1966, Dr. Robert A. Wilson infamously described postmenopausal women as “crippled castrates,” claiming that oestrogen therapy could restore their sexual allure. He even wrote that a woman, once her ovaries stopped working, ceased to be a woman at all.

These ideas—though now outdated—still cast long shadows over how menopause is perceived. They inform the language, the shame, and the bikini-medicine approach to women’s health that we see today.

But here’s the good news: we are finally rewriting the script.

Researchers like Dr. Mosconi, are asking the right questions and putting women’s brains at the centre of the conversation. Science is now starting to understand that menopause is not the end—it’s a powerful recalibration. And with the right knowledge and support, it can become a catalyst for transformation.

Most women will spend up to 40% of their lives post-menopause. That’s too long to live in confusion or silence. The menopause transition is a crucial time to take stock, to care for our brains and bodies with the nourishment, rest, and attention they deserve.

Let’s talk about it. Let’s research it, and let’s pass down our own experiences to our daughters, let’s make menopause mainstream.

If you would like to know more about how the brain is affected by menopause and what precautions and care you can take I highly recommend reading Dr Mosconi’s book ‘The Menopause Brian’

If you are looking for menopause or per-imenopause support book an appointment with our amazing Menopause Naturopath, Debbie Milson – click to book

Citations:

1. Mosconi, L. (2024). The Menopause Brain: New Science Empowers Women to Navigate the Pivotal Transition with Knowledge and Confidence. Penguin Publishing Group. (Goodreads)
2. Mosconi, L. (n.d.). The Menopause Brain. Retrieved from https://www.lisamosconi.com/the-menopause-brain (Lisa Mosconi, PhD)
3. Women’s Brain Health Initiative. (2024). Menopause Brain is Real. Retrieved from https://womensbrainhealth.org/think-tank/menopause-brain-is-real (Women’s Brain Health Initiative)
4. Smithsonian Magazine. (2019). The Statistician Who Debunked Sexist Myths About Skull Size and Intelligence. Retrieved from https://www.smithsonianmag.com/science-nature/alice-lee-statistician-debunked-sexist-myths-skull-size-intelligence-180971241/ (Smithsonian Magazine)
5. Wikipedia. (n.d.). Feminine Forever. Retrieved from https://en.wikipedia.org/wiki/Feminine_Forever (Wikipedia)
6. Healthline. (2024). Menopause Brain Fog: Symptoms, Treatment, Is It Real, and More. Retrieved from https://www.healthline.com/health/menopause/menopause-brain-fog (Healthline)
7. Harvard Health Publishing. (2022). Menopause and Brain Fog: What’s the Link? Retrieved from https://www.health.harvard.edu/womens-health/menopause-and-brain-fog-whats-the-link (Harvard Health)
8. The Times. (2024). ‘Menopause brain’ is real. Here’s how to deal with it. Retrieved from https://www.thetimes.co.uk/article/menopause-brain-is-real-heres-how-to-deal-with-it-gzqpvsl3t (Latest news & breaking headlines)