Menopause and Brain Health: Neurobiological Changes, Cognitive Implications, and the Role of Estrogen.

The menopausal transition is characterized by significant hormonal fluctuations, culminating in a decline in estrogen levels. This decline impacts synaptic plasticity, neurotransmitter regulation, the blood brain barrier, cerebral blood flow, and metabolism, leading to cognitive symptoms often described as brain fog. Menopause-related cognitive changes, often transient, differ from the progressive decline seen in Alzheimer's Disease (AD). Research continues to explore estrogen's role in AD risk, but current evidence does not support using exogenous estrogen solely for dementia prevention. Hormone therapy can help manage menopausal symptoms and should be personalized based on factors like age, timing, and overall brain health.