The headlines landed this week, and they probably scared you.
Menopause linked to brain changes.
Grey matter loss found in memory regions.
Women's dementia risk explained.
Here's what the Cambridge study actually found, and more importantly, what it didn't say.
What the study found (and what it missed)
Published in Psychological Medicine, this large UK study tracked 125,000 women and analysed 11,000 MRI scans.[1] They found an association between menopause and grey matter changes in brain regions involved in memory and emotion.
That's the headline. But the study found structural change, not functional decline. You can have grey matter changes and still maintain cognitive capacity. Structural change does not equal dementia, and it does not predict your individual outcome.
What the headlines didn't say: these changes appear to be plastic, which means the brain can adapt and reorganize. Studies show grey matter volume often stabilizes and can return after the menopausal transition. The brain adapts to lower oestrogen levels by increasing structural connectivity and building more efficient neural networks in the postmenopausal phase. Many cognitive symptoms (difficulty concentrating, memory lapses) are temporary and improve after the transition, suggesting a remodelling phase rather than permanent damage.
The brain's response to menopause is an adaptive process with substantial potential for recovery, not a fixed decline. And your lifestyle levers influence how your brain responds.
The levers you control
To support your brain to adapt and stay sharp, you need to keep your body calm and stable. This means reducing physiological volatility, the 'rollercoaster' of energy crashes, sleep disruptions, and stress spikes. By stabilising this volatility or balancing your metabolic health, you provide your brain with the steady environment it needs to thrive.
Four powerful levers you can pull to rebalance your metabolic health and support your brain health are:
Glucose stability
Brain fog during menopause is often driven by metabolic volatility, not irreversible decline.[2] Your brain runs on glucose, and when blood sugar swings wildly, cognitive capacity drops. Glucose variability is associated with slower neural processing and cognitive vulnerability.[2]
Takeaway: Prioritise protein and natural fats, to help stabilise blood glucose levels. When eating carbohydrates choose high-fibre options and pair with proteins and fat. Apple with almond butter, not apple alone. Eggs and avocado with toast, not toast by itself.
Movement
Exercise acts as a fertilizer for your brain. It supports neuroplasticity, which is your brain’s ability to rewire itself, learn new things, and bounce back from stress.
When you move your body, you trigger the release of a special growth protein (BDNF). You can think of this protein as 'Miracle-Gro' for your brain cells. It helps your brain build new pathways and stay flexible.
The end result is functional resilience: a brain that isn't just surviving, but is better able to handle whatever life throws at it.
Try this: 10-minute walk after meals. Bonus: it helps glucose stability too.
Sleep
Deep sleep clears metabolic waste from the brain and consolidates memory. Poor sleep compounds metabolic volatility and drives inflammation.
Practical step: protect the last hour before bed. No screens, no work emails. Find your personal wind-down routine which could include reading, stretching, or journalling to dump your thoughts from the day.
Stress recovery
Chronic cortisol drives inflammation and glucose dysregulation. You cannot eliminate stress, but you can improve recovery.
Try this after a difficult meeting or conversation: 90-second box breathing. Inhale for four counts. Hold for four. Exhale for four. Hold for four. Repeat.
What to do next
Pick one lever. Try it for seven days. Notice what changes.
If your energy improves or your focus sharpens, you've just influenced your functional brain health. That matters more than a headline.
If you want a clinical roadmap tailored to your metabolic profile, I can help. Contact me to get started.
References
Zühlsdorff K, Sahakian B, et al. Emotional and cognitive effects of menopause and hormone replacement therapy. Psychological Medicine. 2025. DOI: 10.1017/S0033291725102845. https://www.cambridge.org/core/journals/psychological-medicine/article/emotional-and-cognitive-effects-of-menopause-and-hormone-replacement-therapy/E9D94A6EB0B8A3C03113A93D34A99FD0
Fonseca et al. Cognitive vulnerability to glucose fluctuations: A digital phenotype of neurodegeneration. Alzheimer's & Dementia. 2025. DOI: 10.1002/alz.70001. https://alz-journals.onlinelibrary.wiley.com/doi/full/10.1002/alz.70001
