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I always thought of menopause in terms of an end to periods, an end to my reproductive life. I was surprised when I found out that as well as being a change in reproductive state, menopause is also defined as a neurological transition i.e. a change in the nervous system (including the brain). A substantial 80% of menopausal symptoms are thought to originate in the nervous system, including, hot flashes, disturbed sleep, mood changes and memory issues (Mosconi et al 2021). Learning this it might not surprise you that scientists are investigating links between menopause and Alzheimer’s Disease.

A key link between menopause and the brain is that a decline in the hormone oestrogen affects the brain’s access to energy. As explained in my blog “Menopause – feel like you are losing your mind…?” https://bitesize-nutrition.com/menopause-feel-like-you-are-losing-your-mind/ glucose is the main source of energy for the brain. Like every other part of our bodies, the brain needs energy to function as well as to repair and maintain itself.

Poor access to, or ability to use, glucose has been termed the brain-energy gap. The brain-energy gap is thought to be a key event that leads to death, damage and dysfunction of neurons in the brain. Our brain’s ability to access and use glucose generally declines during ageing but this decline is accelerated in people with a genetic risk of dementia or in women who are post-menopausal.

Another possible link between menopause and Alzheimer’s Disease comes from the amyloid-beta plaques in the brain that are a hallmark of Alzheimer’s Disease. There is evidence from animal studies of a link between dropping oestrogen levels and accumulation of amyloid-beta plaques. This association appears to be more pronounced in people at genetic risk of developing Alzheimer’s Disease. If we are not handling glucose well, we may also not be responding properly to the hormone insulin. This suggests another link with Alzheimer’s disease as one of insulin’s many roles is to protect against harmful plaque formation in the brain.

Current evidence suggests that menopausal stage has significant effects on the brain’s structure, connectivity and energy production. Now for the good news……most brain regions appear to stabilise or recover post-menopause. There is evidence that compensatory mechanisms may come into play after the menopause. Studies have reported a decrement in mental performance during the peri-menopause, however, there is also evidence that after the menopause there is a rebound to pre-menopausal levels. Parallels have been drawn between brain changes in pregnancy and subsequent recovery.

If you are at greater genetic risk of developing Alzheimer’s it is important to remember that it is an increased risk not a diagnosis. Learning more about the possible causes of this increased risk present opportunities for diet and lifestyle choices that might help to reduce risk. One possibility is optimising the brain’s access and use of fuel to produce energy.

Signs and symptoms of poor blood sugar control include sugar or caffeine cravings, as well as signs such as fatigue, brain fog, headaches, shakiness, anxiety or irritability when you go more than 4-5 hours without eating. If you suspect poor blood sugar management you could discuss further testing with your GP or a nutritionist or simply work with them to try a supportive diet and lifestyle such as cutting back on sugar and caffeine, eating a source of protein with every meal, increasing fibre intake, optimising sleep etc.

One of the ways in which the brain may adapt during perimenopause is to use fat burning as an alternative fuel to produce energy. In order to be able to switch between fuels in this way we need to be ‘metabolically flexible’. You might therefore wish to discuss with a nutritionist how you could support this, such as whether intermittent fasting might be helpful to you.

Optimising your body’s ability to balance it’s blood-sugar levels brings lots of potential benefits, for example, better energy levels, weight management, mood, and lower inflammation (involved in a whole host of age-related health conditions). If you are curious to find out more about how we might work together to support your health please do get in touch to book a free discovery call.

Zoe Thurston

[email protected]

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