Female Brain Changes Differ in Puberty, Pregnancy
A new study finds puberty and pregnancy trigger similar widespread gray matter loss in the female brain, while menopause temporarily pauses typical
Puberty and pregnancy are associated with similar, widespread reductions in gray matter volume in the female brain, while the menopausal transition presents a distinctly different pattern, temporarily halting typical age-related brain changes. These findings come from a longitudinal brain imaging study led by Sophie R. Van ‘t Hof of the Pregnancy Brain Lab at Amsterdam University Medical Center, which analyzed data from 1,095 participants.
The research aimed to map shared and distinct patterns of brain plasticity across three major hormonal life events. The human brain processes information using gray matter, the tissue that makes up the cerebral cortex and is responsible for high-level functions like memory and emotion. Substantial shifts in sex steroid hormones like estrogen during puberty, pregnancy, and menopause can influence the brain's physical structure.
Comparing Three Hormonal Transitions
By applying identical analytical methods to longitudinal MRI data from three separate groups, the scientists tracked changes in gray matter volume over time. To isolate changes tied specifically to the hormonal transitions, the researchers included age-matched control groups of participants who were not actively transitioning during the study period.
The analysis was divided into three distinct cohorts.
| Cohort | Participant Groups | Key Gray Matter Change |
|---|---|---|
| Puberty | 142 girls (49 pre-menarche, 34 transitioning, 59 post-menarche) | Transitioning girls showed accelerated reductions of 0.13-0.16% per month. |
| Pregnancy | 110 women (40 in first pregnancy, 30 in second pregnancy, 40 nulliparous controls) | Women in first or second pregnancy showed reductions of about 0.12% per month. |
| Menopause | 843 women (120 transitioning, 49 premenopausal controls, 674 postmenopausal controls) | Transitioning women showed a pause in typical age-related volume loss. |
Distinct Patterns of Change
In the puberty and pregnancy cohorts, transitioning participants showed clear, accelerated reductions in cortical gray matter volume. The control groups in these studies did not display similar changes. For pregnancy, the changes were consistent whether it was a woman's first or second child.
The menopause findings provided a stark contrast. The stable premenopausal and postmenopausal control groups showed typical aging-related brain shrinkage, losing 0.025 to 0.033 percent of their cortical gray matter per month. However, women actively transitioning through menopause showed no statistically significant reduction in volume during that period.
Sophie van ‘t Hof explained the contrast to PsyPost. As we see increases in sex hormones during puberty and pregnancy, and those changes have been linked in previous work with the gray matter reduction, we wanted to know, during menopause, when sex hormones decrease, what happens to the gray matter? The data suggested a decrease in sex hormones leads to "a pause in the decrease."
Regional Overlap and Divergence
When comparing specific brain regions across all three cohorts, the researchers found both overlap and divergence. In 34 regions of the cerebral cortex, primarily higher-order areas involved in complex thought and memory, puberty and pregnancy were associated with highly similar rates of gray matter reduction.
Other areas displayed a stepwise pattern. In 33 regions, primarily related to sensory processing and movement, pubertal transition coincided with the largest gray matter decline, pregnancy with a moderate decline, and menopause with the least. A small cluster of brain regions, including areas involved in emotion and internal bodily sensations, showed strong declines only during puberty.
Van ‘t Hof emphasized that the functional meaning of the menopause finding remains unclear. "For puberty and pregnancy we have more hypotheses, brain changes seem to have a specific function," she said. But for menopause we don't know yet.
Susana Carmona, head of the Neuromaternal Research Group at Instituto de Investigación Sanitaria Gregorio Marañón, who was not involved in the study, called it a much-needed piece of work. She told PsyPost the team had carried out a study long awaited, comparing the three neuroendocrine transitions most women experience.
