Evidence map›Paper›PMID 41587742›Full record

ArticlePsychological medicine2026

Emotional and cognitive effects of menopause and hormone replacement therapy.

Katharina Zuhlsdorff, Christelle Langley, Richard Bethlehem, Varun Warrier, Rafael Romero Garcia, Barbara J Sahakian

Abstract read
In one paragraph

Article in Psychological medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Article
  2. Article
  3. Menopausal insomnia as a modifiable node of dementia risk: Mechanistic insights and intervention strategies.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026
    Review
  4. Article
  5. Review
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Katharina ZuhlsdorffUniversity of Cambridge Department of Psychology, UK.ORCID https://orcid.org/0000-0002-8501-4529
Christelle LangleyUniversity of Cambridge Department of Psychiatry, UK.ORCID https://orcid.org/0000-0001-5061-2820
Richard BethlehemUniversity of Cambridge Department of Psychology, UK.ORCID https://orcid.org/0000-0002-0714-0685
Varun WarrierUniversity of Cambridge Department of Psychology, UK.ORCID https://orcid.org/0000-0003-4532-8571
Rafael Romero GarciaUniversity of Cambridge Department of Psychiatry, UK.ORCID https://orcid.org/0000-0002-5199-4573
Barbara J SahakianUniversity of Cambridge Department of Psychiatry, UK.ORCID https://orcid.org/0000-0001-7352-1745

Funding

Wellcome Trust 223082/Z/21/Z
6 · The paper itself

Abstract

backgroundMenopause is a natural physiological process, but its effects on the brain remain poorly understood. In England, approximately 15% of women use hormone-replacement therapy (HRT) to manage menopausal symptoms. However, the psychological benefits of HRT are not well established. This study aims to investigate the impact of menopause and HRT on mental health, cognitive function, and brain structure.

methodsWe analyzed data from nearly 125,000 participants in the UK Biobank to assess associations between menopause, HRT use, and outcomes related to mental health, cognition, and brain morphology. Specifically, we focused on gray matter volumes in the medial temporal lobe (MTL) and anterior cingulate cortex (ACC).

resultsMenopause was associated with increased levels of anxiety, depression, and sleep difficulties. Women using HRT reported greater mental health challenges than post-menopausal women not using HRT. Post-hoc analyses revealed that women prescribed HRT had higher levels of pre-existing mental health symptoms. In terms of brain structure, MTL and ACC volumes were smaller in post-menopausal women compared to pre-menopausal women, with the lowest volumes observed in the HRT group.

conclusionsOur findings suggest that menopause is linked to adverse mental health outcomes and reductions in gray matter volume in key brain regions. The use of HRT does not appear to mitigate these effects and may be associated with more pronounced mental health challenges, potentially due to underlying baseline differences. These results have important implications for understanding the neurobiological effects of HRT and highlighting the unmet need for addressing mental health problems during menopause.

Indexed as

CognitionEmotionsGray MatterGyrus CinguliHormone Replacement TherapyMenopauseTemporal LobeAgedAnxietyDepressionFemaleHumansMagnetic Resonance ImagingMiddle AgedSleep Wake DisordersUnited Kingdomanterior cingulate cortexcognitionentorhinal cortexhippocampushormone replacement therapymenopausemental health

Identifiers

PMID41587742
PMCPMC12885352

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.