Beyond Hot Flashes: Menopause and Your Future Brain

The hormonal shifts of menopause affect more than just the body—they may also shape your cognitive future. This fascinating deep dive explores groundbreaking research that reveals a surprising connection: the more menopause symptoms a woman experiences, the greater her risk for cognitive and behavioral changes later in life.

We unpack findings from a comprehensive Canadian study of 896 postmenopausal women that tracked eleven common menopausal symptoms and their correlation with cognitive function. For every additional symptom women reported—from hot flashes to sleep problems—researchers found a 5.37% increase in self-reported cognitive difficulties later in life. Similarly, each extra symptom corresponded with a 6.09% higher score on measurements of mild behavioral impairment (MBI), subtle changes increasingly recognized as potential early warning signs of dementia risk.

The connection remained strong even after accounting for factors like age, education, type of menopause, and hormone therapy use. While hormone therapy didn't significantly affect cognitive outcomes in this study, women using estrogen-containing treatments showed nearly 27% fewer behavioral symptoms later on. This suggests menopause isn't simply a temporary inconvenience but potentially a crucial window into a woman's future brain health.

Rather than focusing on specific symptoms in isolation, this research highlights the importance of the total symptom burden as a potential indicator of how your body handles hormonal transitions. For women navigating menopause or concerned about cognitive aging, these findings emphasize the value of tracking symptoms, understanding your unique experience, and working with specialized healthcare providers who can help you create personalized strategies to support long-term brain health.

Disclaimer:
The information provided in this podcast is for educational purposes only and is not intended as medical advice. Always consult with a qualified healthcare professional before making changes to your supplement regimen or health routine. Individual needs and reactions vary, so it’s important to make informed decisions with the guidance of your physician.

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Chapters

• 0:36 Introduction to Menopause Beyond Physical Symptoms
• 2:41 Understanding Menopausal Symptom Burden
• 4:50 Connections Between Symptoms and Cognitive Function
• 6:30 Exploring Mild Behavioral Impairment (MBI)
• 8:46 Hormone Therapy Effects and Research Findings
• 10:58 Personalized Care Options for Menopausal Women

Transcript

Speaker 1: 0:18

We hear so much about menopause. You know hot flashes, sleep changes. But what if there's more to the story, like deeper stuff?

Speaker 2: 0:25

Yeah.

Speaker 1: 0:26

What happens during this time for women, Like it really affects their mental and cognitive well-being, you know, as they get older.

Speaker 2: 0:33

Definitely.

Speaker 1: 0:34

I've been digging into some research and it's pretty interesting.

Speaker 2: 0:36

Absolutely. While we always focus on the physical changes during menopause, there's this study in PLOS1 that looked at how the number of symptoms might be linked to cognitive function and even behavior changes later in life. Wow, it makes you think. Maybe how the body reacts overall to these hormone shifts is really important.

Speaker 1: 0:55

Totally, and this isn't some tiny study. They use data from the CanProtect study in Canada. It's all about brain aging and they looked at 896 women who had gone through menopause.

Speaker 2: 1:06

Right, a good sample size.

Speaker 1: 1:08

So that gives the findings some real weight.

Speaker 2: 1:10

Exactly that's why we're doing this deep dive today. We want to unpack what this research tells us about these possible long-term mental and cognitive effects of menopause, and we'll look at hormone therapy too, because that's a big part of it all.

Speaker 1: 1:22

Definitely so. This idea of menopausal symptom burden keeps coming up.

Speaker 2: 1:26

Right.

Speaker 1: 1:27

When we talk about the number of symptoms, what are we actually counting?

Speaker 2: 1:30

So they define it pretty simply. It's the total number of perimenopausal symptoms the women remembered having. They gave them 11 common symptoms and they literally just counted how many each woman said she experienced.

Speaker 1: 1:42

So 11 symptoms that's helpful. Can you list them so we have a clear picture?

Speaker 2: 1:45

Of course, it included irregular periods hot flashes and chills, vaginal dryness, weight changes like gain and feeling like your metabolism slowed down. Right Night sweats.

Speaker 1: 1:57

The worst.

Speaker 2: 1:58

Sleep problems, mood symptoms, problems with focus or memory, and then a category for any other symptoms they had.

Speaker 1: 2:06

Okay, so pretty thorough.

Speaker 2: 2:07

Yeah, they wanted to cover all the common experiences during perimenopause.

Speaker 1: 2:11

Got it, so each woman had a number tied to her, basically how many of those 11 she remembered.

Speaker 2: 2:17

Right.

Speaker 1: 2:18

And then they compared that to her cognitive abilities. Later on, what did they find?

Speaker 2: 2:22

This is where it gets interesting. The main finding was a link between a higher number of symptoms and poorer cognitive function later in life.

Speaker 1: 2:30

Wow.

Speaker 2: 2:30

They found that for each additional symptom, a woman remembered her score on the Everyday Cognition Scale or ECOG2, was 5.37% higher on average to was 5.37% higher on average. Now remember a higher score on that scale means more self-reported issues with everyday thinking tasks. So basically, the more symptoms during menopause, the more cognitive challenges they reported later on.

Speaker 1: 2:53

That's a strong connection. It makes you wonder, though were there other factors involved? Did they just look at the number or consider other things that we know affect cognitive function as we age?

Speaker 2: 3:03

You're right, they were very careful about that. They took into account age, education level, age at menopause, whether menopause was natural or induced by surgery or meds and, importantly, whether they'd use hormone therapy. By adjusting for these things, they tried to zero in on the specific impact of the number of symptoms.

Speaker 1: 3:19

So they really isolated that one variable. What about the type of menopause or the age it started? Did those matter?

Speaker 2: 3:25

It's interesting In this study those things didn't show a strong independent link with cognitive function later on. The number of symptoms was the more important factor. Here it seems like maybe how the body experiences the hormonal shift, as seen in the total symptom count, might be key.

Speaker 1: 3:43

Interesting. Now they also studied something called mild behavioral impairment or MBI. Can you explain what that is and why it matters in this whole menopause and aging conversation?

Speaker 2: 3:59

Sure MBI is when you have new and persistent behavioral and neuropsychiatric symptoms starting later in life usually after 50. Okay, and it's not due to an existing psych condition.

Speaker 1: 4:04

Right.

Speaker 2: 4:05

Think. Subtle shifts in personality, motivation, social behavior. What makes it important is that research shows these changes can be early signs of a higher risk for cognitive decline and even dementia later on.

Speaker 1: 4:15

We thought of a warning sign.

Speaker 2: 4:16

Exactly.

Speaker 1: 4:16

What specific behaviors do researchers look for with MBI?

Speaker 2: 4:19

They use the mild behavioral impairment checklist or MBIC. It looks at five areas Effect, which is about changes in emotional expression, impulse discontrol, social cognition so how we process social stuff and interact and psychosis-like symptoms.

Speaker 1: 4:37

So a broad range of subtle but possibly important changes.

Speaker 2: 4:41

Yeah.

Speaker 1: 4:42

And they look at whether the number of menopause symptoms was linked to these MBI symptoms later on. What did they find?

Speaker 2: 4:47

Similar to cognitive function. A higher number of symptoms was linked to a higher burden of MBI symptoms. Later on, For every extra symptom a woman remembered, her score on the MBIC was 6.09% higher.

Speaker 1: 5:00

Wow, so more behavioral changes reported.

Speaker 2: 5:02

Right.

Speaker 1: 5:02

So it's like the symptom burden might be a wider indicator of how the body handles the hormone changes maybe affecting thinking and behavior as we age. Possibly and I'm guessing they accounted for those other factors here too- you bet.

Speaker 2: 5:14

Throughout the analysis they adjusted for age, education, age at menopause, type of menopause and hormone therapy use.

Speaker 1: 5:21

Okay, good to know.

Speaker 2: 5:21

This makes the link between symptom burden and these later changes even stronger.

Speaker 1: 5:26

Very cool. Let's talk about hormone therapy.

Speaker 2: 5:29

Yeah.

Speaker 1: 5:29

How did the study categorize HT use and what did they find about its connection to cognitive function and MBI?

Speaker 2: 5:37

They had three groups based on HT use. Those who never used it, those who used progestin only or unspecified types. And those who used various estrogen-containing HT like estradiol, conjugated estrogen or combos with estrogen and progesterone or progestin.

Speaker 1: 5:52

Okay, so they did break it down some.

Speaker 2: 5:53

Yes.

Speaker 1: 5:54

What about HT and cognitive function measured by that ECOG2 scale?

Speaker 2: 5:57

Interestingly, they didn't find a statistically significant link between any type of HT and those scores. So in this study hormone therapy wasn't linked to how women perceive their cognitive abilities later on.

Speaker 1: 6:08

That's interesting because we hear so much about HT and brain health.

Speaker 2: 6:11

I know right.

Speaker 1: 6:12

What about MBI symptoms? Was there any effect there?

Speaker 2: 6:14

Yes, this is where the results were different For the group using estrogen-containing or combo therapies. There was a link to lower total MBIC scores.

Speaker 1: 6:23

Really.

Speaker 2: 6:24

This suggests HT might help reduce some of those behavioral symptoms that can show up later. They found that HT use was linked to a 26.90% lower score on the MBIC.

Speaker 1: 6:37

That's pretty significant, definitely so. Ht didn't show a strong link to cognitive function here, but it did seem to help with mild behavioral symptoms Right. Did they look at whether age at menopause or using HT could actually change the relationship between that initial symptom burden and the outcomes?

Speaker 2: 6:53

Yes, they did those analyses, but neither age at menopause nor HT use significantly changed the basic relationship they found between the number of symptoms and later cognitive function or MBI.

Speaker 1: 7:04

So that initial number of symptoms seems to matter no matter what Right. What are the main takeaways from this research? What do the authors conclude about what this means for women's health as they age?

Speaker 2: 7:13

They concluded that having more menopause symptoms might mean you're more susceptible to both cognitive and behavioral changes later on. They emphasize that these changes, especially with MBI, are being recognized more and more as possible early signs of dementia risk. This suggests that menopause might be a crucial time for understanding a woman's long-term brain health. That makes sense. Yeah, this suggests that menopause might be a crucial time for understanding a woman's long-term brain health.

Speaker 1: 7:33

That makes sense. Yeah, it's really interesting that they focus on the total number of symptoms.

Speaker 2: 7:37

Yeah.

Speaker 1: 7:38

We usually hear about specific symptoms being linked to things.

Speaker 2: 7:41

Right. While other research has looked at individual symptoms and cognitive changes, this study highlights the overall number of symptoms as a potential broader indicator. It could be that the combined effect of the symptoms is more important than any single symptom for long-term brain health.

Speaker 1: 7:58

That makes sense. Now, this is complex stuff, like anything with hormones and the brain.

Speaker 2: 8:02

Yeah.

Speaker 1: 8:03

Do they talk about any limitations or things to keep in mind?

Speaker 2: 8:06

Oh, for sure, they mentioned several limitations. Like we discussed, it was a cross-sectional study study, so they can't say for sure if the symptoms caused the later changes or just a correlation exactly, and they only counted the number of symptoms, not how intense or long they lasted, which could also matter okay their list of 11 symptoms might not have captured every single experience and they didn't have all the details about specific types, dosages and durations of hormone therapy, and they didn't go into a ton of detail about different types of surgical menopause.

Speaker 1: 8:34

Okay, good to know. Were there any strengths they highlighted?

Speaker 2: 8:37

Absolutely. They pointed out that they looked at lots of menopause-related factors together in one analysis, like type, age of onset, HT use. They also stressed the value of assessing both cognitive function and those subtle behavioral changes from MBI. It gives a more complete picture and the big sample size from CanProtect makes the findings even more solid.

Speaker 1: 9:00

This research gives us a lot to think about when it comes to women's health and what might happen long-term after menopause.

Speaker 2: 9:06

Definitely.

Speaker 1: 9:07

So for our listeners going through menopause or who've been through it or are worried about mental and cognitive health as they get older, what's the main takeaway?

Speaker 2: 9:16

The big thing is that your experience during menopause, especially the number of symptoms, might give you clues about your chances of cognitive and behavioral changes later on. This study doesn't prove cause and effect, but the connection is strong enough that you should pay attention and be proactive about your health. It's all about tuning into your body signals during this big hormonal shift.

Speaker 1: 9:37

What about women who want personalized guidance and support as they go through menopause and want to be proactive about their mental and cognitive health? Where can they go?

Speaker 2: 9:46

If you're in Florida or looking for really comprehensive and forward-thinking care, I want to mention LifeWellMDcom. They're right here in Florida and they specialize in health, wellness and longevity. Dr Kumar and the team get the many challenges women face during menopause, including the possible effects on mental and cognitive well-being. They have a truly personalized approach to women's health.

Speaker 1: 10:08

It sounds like they go deeper than a typical doctor's office. What kind of specific support can someone find there?

Speaker 2: 10:14

They do thorough evaluations to understand your unique experience. You'll have in-depth talks about all your symptoms and potential interventions, including different types of hormone therapy. They don't just focus on the physical symptoms, but also mental and cognitive well-being. They help you navigate this phase in a way that optimizes your long-term health, and they work with you to make a personalized plan.

Speaker 1: 10:37

So it's really important to understand your own experience and talk to specialists.

Speaker 2: 10:40

Absolutely being proactive about tracking your symptoms, understanding your body and talking to experts like Dr Kumar and his team at LifeWellMD can help you make informed choices about your health during and after menopause. It's about taking charge.

Speaker 1: 10:56

As we wrap up, let's recap. The number of symptoms during menopause seems to be linked to cognitive and behavioral well-being. Later, and while hormone therapy wasn't strongly connected to cognitive function in this study, it might be good for those mild behavioral symptoms.

Speaker 2: 11:10

That's a great summary.

Speaker 1: 11:12

Everyone listening. We encourage you to think about your own menopause experience and any worries about your mental and cognitive health as you age.

Speaker 2: 11:18

Right. Self-awareness is key.

Speaker 1: 11:20

And if you're in Florida or want this kind of personalized proactive care, LifeWellMD sounds like a great resource.

Speaker 2: 11:26

You can check out their website anytime, LifeWellMDcom, to learn about their services and how they can help you through menopause and beyond. How?

Speaker 1: 11:33

they can help you through menopause and beyond. And if you're ready to take the next step and see how they can support you, call them a day at 561-210-9999 to set up a consult. That's right. Taking that first step can lead to a healthier and more vibrant future. That number, again, is 561-210-9999.

Speaker 2: 11:51

To close, think about this how could understanding your body's signals during menopause be the key to protecting your brain, health and well-being in the years to come? Research is always changing and your experience is valuable. Talking to the right healthcare professionals can help you create a path to a healthier future.

Speaker 1: 12:06

Great advice. Thanks for joining us for this deep dive.

Speaker 2: 12:08

My pleasure.