The Hidden Relationship Between Hormonal Shifts and Brain Health
While hot flashes during menopause have become an accepted symptom during this significant hormonal shift for women, a 2023 study indicates they may not be as benign as once thought. It has been well established that hot flashes are linked with a decline in memory as well as changes in brain structure, cognitive function, and connectivity, but findings from the University of Pittsburgh shed new light on the association with Alzheimer’s disease. Here we’ll explore what the researchers discovered — and how to reduce the risk of this devastating disease.
Study Links a Common Menopause Symptom to Alzheimer’s
Published in the American Journal of Obstetrics and Gynecology, researchers from the University of Pittsburgh and the University of Chicago established that nighttime hot flashes during menopause are linked to a higher risk of developing Alzheimer’s disease.
“While women’s quality of life absolutely matters and the hot flashes deserve attention for their quality-of-life impacts alone, we also are seeing that these hot flashes may be telling us much more about a woman’s health than we previously thought,” said lead researcher Dr. RebeccaThurston, who also directs the Women’s Biobehavioral Health Program at the University of Pittsburgh.6
She believes Alzheimer’s is a significant health issue for women, as it’s among the top five leading causes of death, where two-thirds of patients are female. Up to a third of women also experience moderate to severe hot flashes, putting them at an increased risk of developing the disease.
Thurston’s team found that hot flashes that take place during sleep were associated with greater markers of amyloid plaque in the brain, which is one of the major factors in Alzheimer’s pathology. She is quick to point out this wasn’t explained by declining estrogen levels or disrupted sleep — there is another mechanism at play, which requires ongoing research to establish.
A later study published in the journal Cureus also found that menopause significantly increases a woman’s risk of developing Alzheimer’s.5 However, the researchers believe there is a link to declining estrogen, which in turn influences glucose metabolism, mitochondrial function, neuronal plasticity, oxidative stress, and neuroinflammation.5 While the team recognizes hormone replacement therapy (HRT) may be a viable option to preserve brain health in women, after the age of 61, HRT can actually increase the risk of dementia. This is why they stress the importance of adopting an anti-inflammatory diet and daily mixed strength and aerobic exercise as safer alternatives.
As I wrote in “Is Menopause Restructuring Your Brain? Here’s What Scientists Have Discovered“, research shows menopause is linked to measurable brain changes, including reduced gray matter in the frontal and temporal lobes and the hippocampus — areas essential for memory and decision-making. This shrinkage is associated with declines in cognitive function, including verbal and spatial skills. Studies also report increased white matter hyperintensities on MRI scans during menopause, particularly in women with early menopause or frequent hot flashes. These lesions are associated with higher risks of cognitive decline, balance issues, mood changes, stroke, and dementia.3,4
Lowering the Risk: Improving Cognitive Function, Sleep, and Hormonal Balance
Truth be told, these findings are sobering for any woman entering or traveling through menopause and beyond. However, there is plenty you can do to lower the risk of Alzheimer’s now, such as: focusing on building mitochondrial health with regular physical activity (both cardio and resistance training); encouraging brain detoxification via the glymphatic system; managing stress and optimizing your circadian rhythm; embracing intermittent fasting and an anti-inflammatory green Mediterranean diet; as well as utilizing specific herbal remedies to calm hot flashes, boost cognitive function, and support deep, rejuvenating sleep. Here are my top recommendations:
Menopause Blend
If you are struggling with the symptoms of menopause, our potent Menopause Blend combines two time-honored herbal remedies to help restore balance and ease your transition.
Black Cohosh Root is a phytoestrogenic powerhouse that helps raise estrogen levels and calm the hormonal fluctuations behind hot flashes and night sweats.
Red Clover delivers natural phytoestrogen isoflavonoids to help relieve hot flashes, support bone health, and serve as a holistically-based alternative to hormone replacement therapy. Use before bed to tackle nighttime symptoms — or anytime throughout the day for ongoing hormonal support.
For sleep disruptions related to menopause, pair with our Sleep Blend Tincture.
YOUR MENOPAUSE BLEND TRULY HELPS
“My 3rd time ordering. It truly helps.” -Lois
Brain Bundle
Give your brain the support it deserves. My Brain Bundle brings together four of our most powerful, science-backed botanicals for cognitive health. All our mushroom tinctures use dual-extracted, fruiting bodies only — never mycelium — for full potency and effectiveness.
Cordyceps supports whole-body vitality, lung function, and brain health, addressing both chronic fatigue and acute cognitive demands.
Lion’s Mane is the cognitive cornerstone of this bundle — promoting nerve function, mental clarity, increased energy, and stress relief.
Reishi is a top-tier adaptogen that shields the body from stress, encourages restful sleep, and strengthens immune function.
Lemon Balm is my personal go-to for brain and mood support — calming anxiety, sharpening focus, and boosting mental clarity.
Discover the healing power of nature — visit Nicole’s Apothecary today and find the perfect herbal remedy for your wellness needs.
Frequently Asked Questions
Can hormonal changes during midlife affect brain health?
Yes. Research shows that hormonal shifts in midlife women are linked to measurable changes in brain structure, cognitive function, and memory — and may increase the risk of cognitive decline later in life.
What is amyloid and why does it matter?
Amyloid is a protein that accumulates in the brain and is one of the key biological markers associated with cognitive decline. Researchers at the University of Pittsburgh found that hot flash symptoms were associated with higher amyloid levels in women.
Is hormone replacement therapy (HRT) safe for protecting brain health?
HRT may help preserve cognitive health in some women, but research suggests that after age 61 it may actually increase the risk of dementia. Always consult your healthcare provider before starting or stopping any hormone therapy.
Are there natural ways to reduce the risk of cognitive decline?
Yes. Research supports an anti-inflammatory diet, regular mixed strength and aerobic exercise, quality sleep, and targeted herbal support as safe, effective strategies for maintaining long-term brain health.
Why are women at greater risk for cognitive decline than men?
Women account for two-thirds of those affected by Alzheimer’s disease. Researchers believe declining estrogen levels play a significant role, as estrogen influences glucose metabolism, neuronal plasticity, and neuroinflammation — all critical to brain function.
Action Steps to Protect Your Brain Health
- Prioritize sleep quality.
Nighttime hormonal disruptions appear to have a deeper impact on brain health than daytime symptoms. Addressing sleep disturbances early may be one of the most important steps you can take. See Nicole’s Apothecary Sleep Blend Tincture for herbal support. - Adopt an anti-inflammatory diet.
Focus on whole foods rich in antioxidants, omega-3 fatty acids, and phytoestrogens — including flaxseed, soy, legumes, leafy greens, and berries to support hormonal balance and reduce neuroinflammation as well as oxidative stress.
- Exercise daily.
A combination of strength training and aerobic exercise has been shown to support cognitive health, regulate hormones, and reduce the risk of decline. Aim for at least 30 minutes most days.
- Balance hormones naturally.
Herbal remedies like black cohosh and red clover contain phytoestrogens that may help stabilize estrogen fluctuations and ease the hormonal symptoms linked to cognitive changes. Nicole’s Apothecary Menopause Blend is formulated with both.
- Support your brain directly.
Adaptogenic mushrooms such as Lion’s Mane, Reishi, and Cordyceps — in addition to Lemon Balm — are clinically studied for their ability to support nerve function, reduce stress, and promote mental clarity. Nicole’s Apothecary Brain Bundle is a convenient option with all four herbal remedies.
Nicole’s Apothecary Products in this Post
Brain Bundle
Menopause Blend Tincture
Sleep Blend Tincture
References
- Rebecca C. Thurston, Pauline Maki, Yuefang Chang, Minjie Wu, Howard J. Aizenstein, Carol A. Derby, Thomas K. Karikari, Menopausal vasomotor symptoms and plasma Alzheimer disease biomarkers, American Journal of Obstetrics and Gynecology. https://doi.org/10.1016/j.ajog.2023.11.002.
- Calle, Andrés et al. “Severe menopausal symptoms linked to cognitive impairment: an exploratory study.” Menopause (New York, N.Y.) vol. 31,11 (2024): 959-965. doi:10.1097/GME.0000000000002422
- Maki, Pauline M et al. “Hot flashes are associated with altered brain function during a memory task.” Menopause (New York, N.Y.) vol. 27,3 (2020): 269-277. doi:10.1097/GME.0000000000001467
- NA. How menopause restructures a woman\’s brain. Menopause, October 2025 DOI: 10.1097/GME.0000000000000002541
- Briceno Silva, Gabriela et al. “Influence of the Onset of Menopause on the Risk of Developing Alzheimer’s Disease.” Cureus vol. 16,9 e69124. 10 Sep. 2024, doi:10.7759/cureus.69124
- “Nighttime Hot Flashes May Signal Alzheimer’s Risk, Pitt Researchers Say” by Ana Gorelova, UPMC: Life Changing Medicine, November 16, 2023. https://inside.upmc.com/nighttime-hot-flashes-may-signal-alzheimers-risk-pitt-researchers-say/
