Abstract
Menopause is under-recognized as a biological and sociocultural contributor to brain health, and scientific understanding of the impact that the menopausal transition has on the brain is minimal. This knowledge gap is particularly detrimental for women who live with neurological conditions. We lack sufficient data to understand the experience of women with established neurological conditions during perimenopause, the mechanisms associated with postmenopausal changes in disease course and how to improve management of neurological conditions in a sex-specific way. Furthermore, approximately two thirds of women experience cognitive concerns during the menopausal transition. Although earlier menopause is associated with a greater risk of cognitive decline, the influence of the menopausal transition on subsequent risk of neurological conditions remains unclear. In this Roadmap, we identify key areas in which research is limited and highlight historical and scientific challenges that have hindered progress in understanding brain health in the context of menopause. To address these challenges, we consider existing knowledge and propose priorities and future research directions to advance our understanding of the relationship between menopause and neurological health and disease.
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Authors and Affiliations
UCSF Weill Institute for Neuroscience, University of California, San Francisco, San Francisco, CA, USA
Riley Bove
Preventive Neurology Unit, Wolfson Institute of Population Health, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
Ruth Dobson
Department of Neurology, Royal London Hospital, Barts Health NHS Trust, London, UK
Ruth Dobson
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R.B. researched data for the article. R.B. and R.D. made substantial contributions to discussion of the content, wrote the article and reviewed and edited the manuscript before submission
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Competing interests
R.B. has received research funding from the National Institutes of Health, National Multiple Sclerosis Society and Department of Defense and from Biogen, Eli Lilly, F Hoffman Laroche and Novartis. R.B. has also received personal fees for consulting or advisory board services from Alexion, Amgen, EMD Serono, Sanofi Genzyme and TG Therapeutics. R.D. has received grants from Biogen, Celgene (now Bristol Myers Squibb) and Merck. R.D. has received personal fees from Biogen, Esai, Janssen, Merck, Novartis, Roche, Sandoz, Sanofi and Teva.
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Bove, R., Dobson, R. Menopause and neurological disorders: a roadmap for research.
Nat Rev Neurol (2026). https://doi.org/10.1038/s41582-026-01244-5
Accepted:03 July 2026
Published:10 August 2026
Version of record:10 August 2026
DOI
:https://doi.org/10.1038/s41582-026-01244-5
