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The brain in transition: Perimenopause through a translational lens
1Department of Psychology & Neuroscience, University of North Carolina, Chapel Hill, NC, United States.
Neuroscience and Biobehavioral Reviews
|May 26, 2026
Summary
Perimenopause causes significant brain changes, affecting structure, function, and molecules. This period highlights brain plasticity and risk, impacting women's cognitive and emotional health.
Area of Science:
- Neuroendocrinology
- Neurobiology
- Brain Aging
Background:
- Perimenopause is a neuroendocrine transition with hormonal variability.
- This variability drives brain remodeling at multiple levels.
- Understanding these changes is crucial for women's midlife health.
Purpose of the Study:
- To review neurobiological changes during perimenopause.
- To synthesize evidence from molecular, cellular, and systems levels.
- To identify perimenopause as a critical inflection point in brain aging.
Main Methods:
- Narrative review of existing literature.
- Synthesis of structural and functional neuroimaging data.
- Analysis of molecular and cellular remodeling evidence.
Main Results:
- Structural changes include gray/white matter alterations in key brain regions.
- Functional imaging shows reorganized prefrontal networks and altered limbic/memory circuits.
- Molecular changes involve altered estrogen signaling, metabolism, and neuroinflammation.
Conclusions:
- Perimenopause triggers a cascade from endocrine instability to brain adaptations.
- This period presents heightened neural plasticity and vulnerability.
- Findings inform early detection and prevention for midlife neural and cognitive health.
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