Menopause Brain Fog and Mood Swings: What New Research Really Means

You've probably seen the recent headlines about menopause affecting the brain and HRT potentially making things worse, I even spoke about it on ITV’s This Morning this week. A big new UK study from researchers at the University of Cambridge and University of Bristol looked at nearly 125,000 women and found some really important patterns around mood, sleep and thinking that we need to talk about openly.

Here's what they actually discovered

The researchers compared women before menopause, women after menopause who never used HRT, and women after menopause who did use HRT. What stood out was:

• Post-menopausal women overall had more anxiety, low mood, sleep problems and tiredness compared to women still having periods

• Among post-menopausal women, those who had used HRT reported higher levels of anxiety and depression than those who hadn't

• Brain scans showed slightly smaller areas involved in memory and emotion regulation in post-menopausal women, especially those who'd used HRT (though the differences were small)

These findings made headlines, but the researchers themselves are clear this doesn't prove HRT causes worse mood or brain changes.

Why this isn't the full story

The key detail is that women who went on to use HRT already had more mental health struggles before starting treatment. They were more likely to have seen their GP or a psychiatrist for anxiety or depression around the time of menopause.

Think of it like this: if someone has bad chest pain, we don't blame statins when they still have chest pain after starting them. Women with the toughest symptoms are the ones most likely to be offered HRT in the first place.

What this really tells us about menopause care

This study shines a light on something I've seen countless times in clinic: menopause is genuinely tough for many women's emotional health and sleep, not just hot flushes. Current NHS guidance still supports HRT for menopausal symptoms including low mood when it starts around this time, because we know night sweats and flushes themselves wreck sleep and mood.

But it also reminds us that good menopause care should always include:

• Asking about your mood, anxiety and sleep (not just physical symptoms)

• Looking at lifestyle, heart health and brain-protective habits

• Making HRT decisions based on your full health picture, not headlines

Five practical things you can do today

Whether you're on HRT, thinking about it, or managing without, here are realistic steps that support mood, sleep and brain health:

1. Speak up about how you're really feeling
Low mood, anxiety or brain fog that lasts more than a couple of weeks? Book that GP chat. We can figure out what's menopause-related, what might need different support, and whether HRT, talking therapy or meds (or a combination) might help.

2. Make sleep your secret weapon
Even small sleep wins matter. Try consistent wake-up times, winding down without screens, watching evening caffeine. If you wake unrefreshed or snore heavily, ask about sleep apnoea – it's common and treatable.

3. Move your body (gently counts)
Brisk walks, dancing around the kitchen, swimming – whatever feels doable. This protects heart, brain and mood simultaneously. Aim for movement most days rather than punishing gym sessions.

4. Check your numbers
Blood pressure, cholesterol, blood sugar – these affect brain health as much as anything. Midlife is prime time for a health check to catch anything early.

5. Stay connected and curious
Phone chats with friends, learning something new, puzzles, reading. Social connection and mental activity genuinely protect your brain over time.

If you're on HRT or thinking about it

This study doesn't change that HRT helps many women tremendously with flushes, sweats and sleep-disrupting symptoms. But it does remind us to use it thoughtfully:

• Tell your clinician about any past mental health struggles

• Review regularly: is it still helping your target symptoms?

• Consider it one piece of a bigger mood/sleep support plan

When to get urgent help

Please don't wait if you:

• Have thoughts of harming yourself

• Notice sudden severe memory problems or confusion

• Feel completely unable to cope with daily life

Contact your GP, NHS 111, crisis services or A&E. You don't need to suffer.

The bottom line? This study validates that menopause affects women emotionally and cognitively, often more than we talk about. That's not scaremongering – it's an opportunity to improve care. If you're struggling, please reach out. We're here to help you feel more like yourself again.

General information only. For personalised advice, please speak to your GP or paediatric services.