Unveiling the Mind Maze of Menopause: Essential Tips to Navigate the Effects on Your Brain

Editors note: Season 8 of the podcast Chasing Life with Dr. Sanjay Gupta returns to fundamental topics by taking a thorough look at the brain in various states. Each episode will concentrate on a specific state such as the distracted brain, the frightened brain, the nourished brain, and more, to shed light on the inner workings of our minds and its impact on our physical well-being.

(CNN) Menopause, the natural cessation of a woman's reproductive abilities, is an experience that approximately half of the global population will undergo if they live long enough. However, this important stage of women's health, like many other aspects, remains poorly understood.

The decrease in hormones, notably estrogen, plays a significant role in menopause, causing a decline and eventual halt in fertility. However, women also go through a plethora of additional symptoms during perimenopause (the period leading up to menopause) that extend beyond the reproductive organs. These symptoms include hot flashes, cognitive difficulties, mood swings, fatigue, and disruptions in sleep. Interestingly, only in recent times have researchers discovered that estrogens have an impact that reaches well beyond the uterus and ovaries.

"The revelation that estrogen influences brain function only came to light in 1996," said Lisa Mosconi, an associate professor of neuroscience and the director of the Womens Brain Initiative at Weill Cornell Medicine in New York City, during a conversation with CNN's Chief Medical Correspondent, Dr. Sanjay Gupta. "To put it into perspective, this was 30 years after men first set foot on the moon."

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Study finds that 1 in 4 women may experience a heart condition after reaching menopause. Mosconi and her research team conducted brain imaging on over 160 women aged 40 to 65. The women included those who were still premenopausal, perimenopausal, and postmenopausal (no periods for over a year).

The findings were both astonishing and groundbreaking: women experienced a significant restructuring of their brains. In essence, certain areas decreased in size, while others expanded, and there were rewired regions. (Although her article, published in Nature Scientific Reports in 2021, Mosconi continually added women's brain scans to her database.)

"Menopause, being the third of the three phases—puberty, pregnancy, and perimenopause—that the female brain undergoes in a lifetime, holds substantial similarities from a neurological standpoint. Despite the varied cultural and societal perspectives, these phases entail substantial changes in both the brain and the body," Mosconi clarified.

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The workplace can be challenging for women experiencing menopause, but employers are beginning to take action. Discussing the brain changes that occur during this phase, Mosconi emphasized the significance of the neurological system connecting the brain and ovaries. This system plays a crucial role in reproduction, pregnancy support, and needs to be gradually disassembled once reproductive capacity ceases.

"And each of these three phases carries both vulnerability and resilience. Menopause can bring about a range of unpleasant symptoms, but it also offers a potential for resilience. Unfortunately, the aspect of resilience has been widely neglected in medicine, science, and society," Mosconi commented. She further emphasizes the significance of menopause's impact on brain health during the later stages of life.

Listen to the full Chasing Life podcast episode with Professor Lisa Mosconi and Dr Sanjay Gupta right here:

If you were assigned female at birth, what can you do to weather this major midlife shift in the best way possible? Here are Mosconis top five tips:

Say no to tobacco

The number one tip Mosconi offered is to avoid cigarette smoking, and even passive smoke, calling it "a very selective ovarian toxin."

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"It directly disrupts ovarian tissues, hindering the natural progression of follicles into menstruation," stated Mosconi. "This is why heavy smokers tend to experience menopause earlier than nonsmokers."

Moreover, smoking exacerbates menopausal symptoms, which is undesirable for anyone, noted Mosconi. But that's not all. "Active smoking is strongly discouraged for both menopause and overall brain health," she emphasized. "It significantly heightens oxidation and the production of free radicals throughout the body and brain, accelerating cellular aging. Consequently, it hastens neurological aging, which is certainly not beneficial for anyone."

If you are exposed to second-hand smoke, it is highly recommended to invest in an air purifier. According to her, it holds significant importance as it has the potential to make "a huge difference" in reducing smoke exposure.

Get moving

Mosconis second tip may not surprise anyone, given it has been shown to be so helpful as we age: exercise.

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"Physical activity is really supportive of hormonal health and brain health," she noted.

Eat right

When it comes to hormonal and brain health, aerobic exercise, including brisk walking, provides the most significant benefits. It is particularly effective in reducing the intensity and frequency of hot flashes, addressing brain fog and memory lapses, and enhancing cognitive function. To improve sleep, flexibility, stress reduction, and balance, practicing yoga or Pilates is recommended. And for increasing strength, the preferred options are resistance bands or light weights.

Once again, it comes as no surprise that incorporating a plant-based diet comprising a wide range of whole foods is beneficial for all individuals. As Mosconi suggests, a well-balanced and nutritious diet should be abundant in a variety of fresh produce, fruits, vegetables, and antioxidant-rich foods. It is important to acknowledge that one can never consume an excess of plants, hence why it is encouraged to include a greater quantity of plant-based options in our meals.

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There is extensive research on the relationship between diet and brain health, although there is relatively less research specifically focused on diet and brain health for women. Nevertheless, we possess substantial information in this area. It is evident that plant-based foods are crucial for promoting women's health due to various reasons, including their high fiber content, which aids in regulating estrogen, progesterone, and testosterone levels in the blood, as highlighted by Mosconi. Additionally, these foods are rich in antioxidants.

"The brain, the organ most vulnerable to oxidative stress, experiences a form of inflammation akin to the rusting of brain cells as a result of aging and metabolic activity, said the expert. It is crucial to maintain diets rich in antioxidants to combat the aging process in the brain, particularly for women. Antioxidants, exclusively found in plant-based foods, play a vital role in this regard."

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Prioritize sleep

According to Mosconi, sleep hygiene is crucial for maintaining hormonal health. Restful sleep plays a vital role in various aspects of brain and body health, including immune function, weight management, and memory consolidation.

Talk to a doc about HRT

Hormone replacement therapy (HRT) faced criticism in the past; however, recent studies have shown that when administered appropriately to suitable women, HRT is both safe and effective in alleviating the troublesome symptoms of menopause. This viewpoint is supported by the 2022 North American Menopause Society position statement.

"Mosconi advised discussing hormones with a healthcare professional to determine eligibility for hormone replacement therapy and its potential benefits for you personally."

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"Estrogen plays a crucial role in women, while testosterone is essential for men, and these hormones are not solely involved in reproduction; they hold significant importance in fertility as well as brain health and function," she explained. "They contribute to maintaining an active and youthful brain by providing energy and exhibiting anti-aging effects."

Mosconi demonstrates her commitment to her beliefs. "Being in my 40s and experiencing premenopausal phase, which indicates my regular menstrual cycle, I consider this an opportune moment to take proactive measures. As a result, I engage in numerous activities," she shared.

"I have completely revamped my daily routine in preparation for menopause. From changing my diet to altering my exercise regimen, I have made significant adjustments. Additionally, I place a high importance on maintaining good sleep hygiene through specific practices. Stress reduction techniques have also become a priority for me, and I make a concerted effort to eliminate any environmental toxins from my living space. Furthermore, I diligently track my hormones and menstrual cycles, while also mentally preparing myself for the choice of whether or not to take hormones," she explained. "For more useful tips on taking care of your brain during perimenopause and beyond, check out the full episode here. Don't forget to join us next week on the Chasing Life podcast, where we delve into the effects of concussions on the brain during and after."

CNN Audios Madeleine Thompson contributed to this report.