🧠 This Is Your Brain on Menopause

You don’t need me to tell you this. Heck, you don’t need another study to tell you this (though we do appreciate the studies). But our brains change at menopause, as we’ve seen through Dr. Lisa Mosconi’s groundbreaking brain scan research, which showed stage‑specific declines in gray and white matter volume and brain glucose metabolism during the transition—plus evidence that many of these biomarkers stabilize and some regions recover postmenopause in a large proportion of women, even though not everyone experiences full reversal.

Now a new brain imaging study in Menopause shows, yet again, that the transition from pre‑ to peri‑ to postmenopause is a real neurological event—and one we’re only beginning to understand.

Researchers used resting‑state functional MRI (fMRI) data from 151 women ages 40–55 to look at how different parts of the brain “talk” to each other when you’re simply lying in the scanner at rest. They staged the women as pre‑, peri‑, or postmenopausal using STRAW+10 criteria, which combine hormone levels and menstrual cycle patterns, rather than just going by age.

They found that connectivity in key networks differed by menopause stage. In particular, the connection between a region called the supramarginal gyrus, which is important for verbal working memory and language, and nearby auditory/language areas was weaker in postmenopausal women compared to premenopausal women at rest. A broader network that helps you listen, keep verbal information in mind, and integrate sound with meaning, emotion, and motor plans also showed lower resting‑state connectivity after menopause.

Perimenopausal women sat in the middle, not clearly different from either group—fitting with the idea that perimenopause is a transition state where the brain is actively remodeling. That tracks with Mosconi’s work showing menopause‑related shifts in brain energy use, structure, and connectivity in regions that support memory and cognition.

Interestingly, these findings were not what the researchers expected. Based on previous research from another group, they had hypothesized that functional connectivity would be enhanced in the postmenopausal group compared with the premenopausal group. They now suspect that in postmenopausal women, enhanced connectivity may be recruited on demand when you’re doing a task, while less is needed at rest when there are fewer cognitive demands. That’s a reasonable hypothesis. But it still leaves a big question: Why the differences between pre and post in the first place?

What Does It All Mean?

Which brings us to the big question. What does this all mean? Scientists believe that these changes during the menopause transition may help explain why we can’t find the word for frying pan or remember why we walked into a room, and why we experience other cognitive hiccups. But they still don’t really understand why some women continue to have these issues postmenopause and why hormone therapy doesn’t just “fix” it, or at least most of it.

Currently, Mosconi and other researchers are actively investigating these questions. We’ll keep you posted as results come out. In the meantime, there are lots of ways to take care of your midlife brain: sleep, cardio, resistance training, stress management, managing cardiovascular disease risk, and staying socially connected are all evidence‑backed ways to maintain cognitive health—no matter what your menopause brain is doing.

👟 Finally, a Shoe Designed for Women's Feet

If you’ve noticed your feet feeling different in your 40s and 50s — new discomfort, shoes that used to work suddenly don’t — you’re not imagining it. Hormonal changes affect how your tissues respond to load. And if your shoes were never designed for female physiology in the first place, that gap gets bigger over time.

Hettas built the Alma specifically around women’s anatomy, physiology, and biomechanics — narrow heel cup for secure lockdown without Achilles pressure, a midsole tuned to the female force profile, and a female-specific last that finally gives your forefoot room to move. Backed by SFU’s Run Lab. Built for real women at every stage.

Use code STAYFEISTY for 20% off at hettas.com.

🔥Badass Athlete of the Week Goes To…

This week we’re celebrating longtime community member Inessa Love, PhD, of the SassySilverSurfers, who learned to surf at 50, is still going strong at 55 and devotes herself to celebrating other women who are out there catching waves in their 50s, 60s, and 70s–breaking the narrative of what older women can do.

Keep inspiring, Inessa! 🌊

👉Want a chance to be featured? Click here to share your badass story

Have you registered for FeistyFest yet?!🎉

It's a summer vacation for adults! 🏃‍♀️ 🏋️‍♀️ 🧘‍♀️ 🚴‍♀️ From Sept. 18-20 in Lehigh Valley, FeistyFest will be a Don't Miss event of the fall.

💜 Move: Rides, runs, swims, strength training, yoga, pickleball.

💜 Learn: Real experts with education and info centered on women’s bodies.

💜 Connect: Make new friends and fill your cup with old ones.

LEARN MORE: Check out some of the amazing speakers, and register at feisty.co 🫶

👩🏻‍🔬 Hit Play Research Round Up

We spend a lot of time scouring the latest research for news you can use to stay strong and feisty forever. Here’s what’s making waves this week:

🍑Surgical menopause makes genitourinary syndrome of menopause (GSM) hit harder. In a study of 422 postmenopausal women, those with surgical menopause had about a 23% higher total GSM score than women with natural menopause, with more vaginal dryness (71.6% vs. 57.8%), painful sex (63.3% vs. 51.0%), low libido (67.0% vs. 45.1%), and roughly double the rate of postcoital bleeding (25.7% vs. 12.7%). Given the significant impact on quality of life, early intervention is important. Don’t settle for less.

📆Women with primary infertility appear to reach menopause sooner. A new study finds they hit natural menopause about 1 year earlier than peers, and early menopause (40-44) was more than twice as common (7.6% vs 3.0%), with endometriosis and unexplained infertility driving the biggest shift earlier. If you’ve had primary infertility—especially unexplained infertility or endometriosis—watch for signs of earlier menopause and have a proactive conversation with your provider about hormone therapy and long-term health.

🍈🍈Premenopausal breast density may signal when you’re heading toward menopause. In a new study, women with higher mammographic breast density (which also increases breast cancer risk) before menopause were less likely to reach natural menopause over follow-up, even after accounting for other factors—suggesting denser breasts in midlife track with a later menopausal transition. The authors suggest dense breasts may be a marker of more prolonged ovarian hormone exposure, which could go hand-in-hand with a later menopause.

What's On My Mind...

Sports. Watching the New York Knicks (who as a Philadelphia fan, I don’t even like) win the championship made me emotional. Watching all the World Cup fans singing and celebrating in the streets made me emotional. Watching folks have collective, exciting experiences made me emotional. We spend way too much time divided, staring into a screen on our hand. I freakin’ loved to see humanity out shoulder to shoulder in the streets. We need more of that. Much, much more of that.

Listen to this week's episode of Hit Play Not Pause - Midlife Fueling 101: Essential Sports Nutrition Advice for Peri & Postmenopausal Women with Kristen Arnold, MS, RDN, CSSD

Feisty 40+ is written by Selene Yeager. Editing and ads by Ella Neumann.

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