Hormones and the brain: why women's health is also decided in the brain

For a long time, when we talked about female hormones we mainly thought about fertility, menstruation and reproduction. Today we know their role is far broader.

Oestrogen, progesterone and other sex hormones take part in many processes in the body and have effects on the brain, metabolism, the cardiovascular system and bone tissue. That is why the major hormonal transitions in a woman's life also deserve to be understood from a prevention and longevity perspective.

The brain also responds to hormones

The brain is not immune to hormonal change. Oestrogen receptors are present in different brain regions, including the hippocampus, a structure essential for memory and learning. Current research shows that the activity of these receptors changes during the transition to menopause.

Oestrogen is involved in neuronal plasticity, brain energy metabolism, blood flow and the regulation of inflammatory processes. So when hormone levels fluctuate or decline, some women notice changes that go far beyond the symptoms traditionally associated with menopause.

Where does brain fog come from?

«I am more absent minded.» «I cannot find the words.» «I struggle to concentrate.» These are experiences many women describe during perimenopause and menopause.

Brain fog is a complex phenomenon that is still being researched. It does not necessarily mean cognitive decline. A recent review points out that subjective cognitive symptoms during menopause need further study to better understand their relationship with objective measures of cognitive performance.

What we do know is that hormonal fluctuations can be linked to changes in memory, attention, mood and other brain functions. And here a key idea appears: not everything a woman feels during menopause should simply be attributed to age.

Perimenopause: a stage that deserves more attention

Perimenopause is the transition period preceding menopause and can be marked by significant hormonal fluctuations. Sleep, mood, energy, body composition and cognitive function can all change during this stage.

From a Healthspan perspective, these years can be used as a window for assessment and prevention. It is not about medicalising every change. It is about asking: what is happening in my body and what can I do today to arrive in better shape at the next 10, 20 or 30 years?

Menopause and brain health: a relationship science keeps exploring

Research on menopause and the brain has grown enormously. A study published in Scientific Reports in 2024 used PET imaging to study oestrogen receptors in the brains of women at different hormonal stages. Researchers observed changes in receptor density during the menopausal transition and found associations with certain cognitive and mood symptoms.

Other work has studied how menopause may relate to changes in brain structure, connectivity, energy metabolism and other markers linked to brain wellaging. This does not mean menopause inevitably causes cognitive decline. It means something far more interesting: the female hormonal transition may be an important moment to pay attention to brain health.

So what can we do?

Brain health does not depend on a single hormone or a single intervention. The approach must be comprehensive.

Sleep well. Sleep is essential for cognitive function, mood and recovery.

Maintain muscle. Strength training helps preserve muscle mass and physical function, two pillars of healthy wellaging.

Look after metabolic health. Nutrition, physical activity and control of metabolic factors protect cardiovascular and brain health.

Manage stress. Chronic stress can affect sleep, mood and the ability to concentrate.

Monitor hormonal health. Symptoms must be interpreted within each woman's context. When there are medical indications, hormone therapy options can be assessed individually.

An important clarification: menopausal hormone therapy should not be presented as a universal treatment to prevent dementia or Alzheimer's. Evidence on its cognitive effects and dementia risk depends on factors such as age, timing of initiation, type of treatment and route of administration, and continues to evolve.

The question should not only be «how old are you?»

At SHOMMA we are interested in another question: how are you arriving at those years? Two women of the same chronological age can show completely different profiles of hormonal health, body composition, metabolism, sleep, cardiovascular health and physical function.

That is why we talk about Healthspan. It is not only about adding years to life. It is about increasing the years we live with health, autonomy, energy and the capacity to enjoy.

Female health is a continuum

Hormonal health does not begin at menopause. It starts much earlier and changes throughout life: from adolescence and the reproductive stage to perimenopause, menopause and the decades that follow. Each transition offers information about our body. And each stage can be an opportunity to prevent.

At SHOMMA we believe that understanding your hormones is also understanding part of your brain and metabolic health, and your future. Because living longer is not enough. The goal is to live better.