ICYMI: Study Identifies Gray Matter Reductions Post-Menopause

A new study found gray matter reductions across several brain regions among post-menopausal women.

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Menopause can involve a long list of brain-related symptoms, from insomnia to hot flashes to anxiety. But the neurological changes associated with this transition aren’t well understood. Researchers from the University of Cambridge used a wealth of data, including MRI scans from nearly 11,000 women, to examine what happens in the brain during and after menopause. They found post-menopausal women had less gray matter in brain regions associated with memory, cognition, and emotions. The team also concluded hormone replacement therapy (HRT), an intervention some peri-and-post menopausal people pursue to mitigate symptoms and improve health, doesn’t affect this reduction.

In the central nervous system, gray matter is a type of tissue crucial to our ability to process and use information. Post-menopausal women had less gray matter in the anterior cingulate cortex (a brain region linked to mood regulation and decision-making), the hippocampus (which plays a key role in memory), and the entorhinal cortex (which transmits information to the hippocampus). Alzheimer’s disease, which occurs in women nearly twice as often compared to men, targets these regions, and it’s possible menopause plays a role in this phenomenon.

The gray matter reductions took place regardless of whether a participant took HRT, and in fact, HRT was associated with greater gray matter loss in some parts of the brain. People taking HRT also reported more anxiety and depression than those who didn’t, but the study authors suggested those mood conditions may have been present before menopause onset. They did determine, however, that people on HRT had better reaction times in a card-matching speed game compared to post-menopausal women who weren’t taking it.

Big Picture: HRT involves taking estrogen, a hormone the body produces at much lower levels following menopause. This intervention can alleviate some menopause symptoms, but only a small fraction of people pursue it during or after the menopausal transition. In Nov. 2025, the FDA removed a black box warning it had formerly placed on HRT prescribed for menopausal people, potentially paving the way for increased use. The researchers didn’t assess which type of HRT study participants pursued, nor did they conclude why the observed gray matter reductions occurred in the first place. Understanding how this shift and HRT affect the brain and body more broadly is key to ensuring women going through menopause get quality, effective care. 

Read More: Menopause linked to changes in brain’s gray matter, new study shows. Scientific American

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About the Author

Bella Isaacs-Thomas

Bella is the Staff Writer and Editor for BrainFacts. She previously worked as a digital science reporter at PBS NewsHour, where she was named a fellow in the 2022-2023 class of the National Science-Health-Environment Reporting Fellowships (SHERF) and earned a 2021 D.C. Science Writers Association Newsbrief Award for writing. She graduated from the University of Michigan with a bachelor's degree in 2018.