Hot flashes, night sweats, vaginal dryness, urinary tract infections, irregular periods, low libido, trouble sleeping, brain fog, mood swings — and in rare cases, even a burning tongue sensation. What might all these symptoms have in common? They can all be signs of menopause.
But could these symptoms hint at a greater story? New research suggests that menopause symptoms are not just immediate hurdles to overcome; they might also hold clues about a person’s future health, including their risk for conditions like dementia. However, to understand this connection, we must first understand what menopause is and how it affects the brain and body.
What is menopause?
Menopause marks the natural end of a woman’s menstrual periods, typically occurring in their late 40s or early 50s. Officially, menopause describes the specific day when someone has gone a full year without a period.
However, menopause doesn’t happen overnight. It often starts years earlier with a phase called perimenopause. During this time, the body prepares for menopause, and hormone levels — especially estrogen — fluctuate. This transition can last several years, often bringing symptoms like irregular periods, hot flashes, mood swings and more.
Once periods stop completely, a woman enters postmenopause. Unfortunately, symptoms don’t always end here; some may persist for years, and new symptoms may appear.
These stages — perimenopause, menopause and postmenopause — are all part of the same journey, though each person’s experience is unique.
An all too similar patient’s journey
While menopause is a natural process, its symptoms can feel anything but. Some people may experience mild or no symptoms, while others struggle with numerous and severe symptoms that disrupt daily life.
Symptoms like anxiety can make socializing difficult, sleep problems can lead to exhaustion and brain fog can make even simple tasks feel daunting. Together, these challenges can affect thoughts, feelings and social lives — key aspects to overall health.
Why menopause matters beyond the present
Understanding menopause and its symptoms is just the beginning. Beyond being a transitional phase, the challenges of menopause may offer a unique window into future brain health.
Take Alzheimer’s disease, the most common cause of dementia, marked by progressive memory loss, emotional and personality changes, and eventually, a loss of independence. Women are twice as likely as men to develop Alzheimer’s disease. In the past, research thought this difference was because women live longer than men, but new research suggests that menopause-related hormone changes may also play a critical role.
The role of hormones in brain health
During menopause, the ovaries stop producing eggs, triggering significant hormonal changes. One major change is the drop in estrogen, a hormone not only essential for reproduction, but also brain health.
Estrogen helps protect memory, strengthen neural connections, regulate mood and remove harmful proteins from the brain. When estrogen levels fall, these health benefits may weaken, possibly leaving the brain and body more vulnerable to harmful changes.
During these hormonal changes, menopause symptoms may also emerge. While symptoms were once thought to be temporary, albeit uncomfortable, side-effects of menopause, these symptoms may also signal underlying brain changes linked to dementia risk.
Future cognitive and behavioural health
While past research has examined how individual menopausal symptoms may relate to dementia risk, our research team (led by Dr. Zahinoor Ismail, a physician-scientist) asked: could the number of symptoms experienced also indicate early warning signs of dementia?
We explored this by analyzing changes in:
Cognition (for example, memory, thinking, and problem-solving) and
Behaviour (for example, emotions, personality, and social interactions).
While cognitive changes are often top of mind when thinking about dementia, behavioural changes are equally important but frequently overlooked, and might also be early warning signs.
We examined data from 896 postmenopausal participants in the CAN-PROTECT study, an online Canadian project on aging and brain health. Participants recalled the type and number of symptoms they experienced during perimenopause and completed tests assessing their current cognition and behaviour.
Among the participants, 74.3 per cent experienced perimenopausal symptoms — an average four symptoms per person — with hot flashes (88 per cent) and night sweats (70 per cent) being most common.
Our findings revealed that experiencing more symptoms during perimenopause was associated with greater cognitive and behavioural changes later in life, suggesting the burden of perimenopausal symptoms not only affected immediate well-being, but could also signal long-term brain health risks.
While the underlying mechanisms remain unclear, these findings highlight the importance of recognizing menopausal symptoms as potential early indicators of future brain health.
Interestingly, participants who used estrogen-based hormone therapies for perimenopausal symptoms showed fewer behavioural changes than non-users, suggesting a possible role for estrogen in dementia risk reduction. However, further research is critical to clarify the timing and long-term effects of hormone therapy.
It’s important to understand that these findings show a relationship between symptom burden and later brain health, but do not prove that one causes the other. We still need more research to understand why a connection exists and how it works.
Why this research matters
Our research highlights a crucial link: experiencing multiple perimenopausal symptoms may be related to cognitive and behavioural changes, which are early risk markers of dementia. Recognizing these symptoms as potential warning signs could help health care providers identify risks sooner and explore ways to protect brain health over time.
Menopause is more than a life transition; it may offer critical insights into long-term brain health. Supporting research like CAN-PROTECT, which is still recruiting participants, can help us uncover how menopause experiences shape dementia risk, paving the way for earlier interventions and better outcomes.
Zahinoor Ismail receives funding from Canadian Institutes of Health Research.
Jasper Crockford and Maryam Ghahremani do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.
This article was originally published on The Conversation. Read the original article.
