Menopausa e Encéfalo: O que revela a Literatura Científica

Abstract

The menopausal transition (MT) is a phase experienced by women during midlife, characterized by profound hormonal changes that may affect multiple aspects of physical and mental health. During this period, the decline in estrogen and progesterone production leads to physiological alterations that can impact several body systems, significantly influencing brain function in women undergoing this transition. The aim of this review was to evaluate the morphological and bioenergetic brain changes associated with menopause in the context of female aging, as well as to discuss the options and effects of hormone therapy for managing the alterations experienced during this period. This was conducted through the selection of scientific articles derived from research studies carried out exclusively in women (human subjects), published between 2014 and 2024 in the PubMed database. The findings indicate that the female brain undergoes substantial changes during the MT, including marked reductions in gray matter volume in more rostral regions, such as the frontal and temporal cortices, as well as in limbic areas including the hippocampus and amygdala—regions that play key roles in the modulation of cognitive functions, memory, and emotions. In addition, increases in white matter hyperintensity volume were observed, potentially rendering the brain more susceptible to dementia, alongside metabolic and bioenergetic transitions. Hormone replacement therapy (HRT) appears to exert a neuroprotective effect; however, this effect is dependent on factors such as the timing of treatment initiation, the specific formulation used, and dosage. The lack of longitudinal studies, as well as inconsistencies in HRT protocols, represent notable limitations in the literature reviewed and highlight the need for further research aimed at achieving a more comprehensive understanding of female brain aging.