Postmenopausal confusion

Postmenopausal confusion is a symptom of menopause; women face problems with cognition during and after menopause due to hormonal imbalances.

Estrogen affects the serotonergic, cholinergic, dopaminergic, and noradrenergic systems, all of which are key to maintaining regular functioning in both survival and cognition. Seratonin and dopamine also play key roles in mood, which alters drastically with menopause as these hormone levels decrease, as a result of estrogen decline. Furthermore, the ratio of testosterone to estrogen changes as testosterone is now of higher quantity, causing a more easily angered disposition and allowing stress to seem more prevalent than before menopause.

During menopause, the amygdala, which controls emotion, and the prefrontal cortex, which regulates judgment, become more regular. Estrogens, a group of hormones including estradiol and estrone, are secreted by the ovaries and the secretion is regulated by leutenizing hormone (LH) and follicle stimulating hormone (FSH), both of which are produced by the pituitary gland. In women, estrogen levels fluctuate during the menstrual cycle but reach a steady decline and then remain at low levels postmenopause.

Behavioral studies suggest that estradiol augments cognition that occurs within the prefrontal cortex and hippocampus. It can also enhance long term potentiation (LTP) which is key at the neurocellular level for memory and learning and is mostly affected at the neuroanatomical level of CA1 pyramidal cells, NMDAr receptors, and AMPAr receptors.

Microglia are glial cells in the brain that make estrogen and produce cytokines and immune proteins in response to estrogen. These cells play a large role in neuroinflammation which can in turn lead to disorders such as Multiple Sclerosis, Alzheimer's disease, and Parkinson's disease. Estrogen can play an anti-inflammatory role with microglia, which can protect the CNS against the stimuli that promote such diseases.

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