Puberty, pregnancy, and menopause show shared and distinct structural changes across the lifespan

Nature Communications, vol. 17

Abstract

The female brain undergoes substantial reorganization during major hormonal transitions, yet whether puberty, pregnancy, and menopause engage shared or distinct neuroplastic mechanisms remains unknown. We compared longitudinal structural brain changes across all three major hormonal life events using identical analytical methods within a single cohort framework (n = 1095), with stable control groups to control for normative developmental and aging trajectories. Both pre-to-post menarche and pre-to-post pregnancy groups showed widespread cortical gray matter reductions, with cross-cohort comparisons revealing divergent profiles across more than half of cortical regions alongside convergence in prefrontal, parietal, and temporal association cortices. Pre-to-post menopausal women showed a fundamental divergence from both puberty and pregnancy, as they showed no volumetric loss, while stable pre- and postmenopausal control groups did. Puberty and pregnancy thus share both convergent and divergent cortical remodeling, while menopause represents a qualitatively distinct pattern, defined by the absence rather than acceleration of volumetric change. Brain volumes decline during puberty and pregnancy, with both shared and distinct regional patterns, while menopause appears to briefly pause rather than speed up ongoing volume loss, as shown by this neuroimaging study directly comparing these three transitions.

Authors 5

1. Sophie R. van ’t Hof corresponding

   Amsterdam UMC Location University of Amsterdam · Amsterdam Neuroscience · Amsterdam University Medical Centers · University of Amsterdam

   Affiliation as printed

   Department of Psychiatry, Pregnancy Brain Lab, Amsterdam Neuroscience, Amsterdam Reproduction and Development, Amsterdam University Medical Center (AUMC), location University of Amsterdam, Amsterdam, the Netherlands

2. Marieke Geerte Nynke Bos Aachen Department of Developmental and Educational Psychology Institute of Psychology, Leiden University Leiden Institute for Brain and Cognition

   Leiden University

   Affiliation as printed

   Department of Developmental and Educational Psychology, Institute of Psychology, Leiden University, Leiden, The Netherlands

   Leiden Institute for Brain and Cognition, Leiden University, Leiden, the Netherlands

3. Milou Straathof

   Amsterdam UMC Location University of Amsterdam · Amsterdam Neuroscience · Amsterdam University Medical Centers · University of Amsterdam

   Affiliation as printed

   Department of Psychiatry, Pregnancy Brain Lab, Amsterdam Neuroscience, Amsterdam Reproduction and Development, Amsterdam University Medical Center (AUMC), location University of Amsterdam, Amsterdam, the Netherlands

4. Eveline A. Crone

   Erasmus University Rotterdam

   Affiliation as printed

   Erasmus School of Social and Behavioral Sciences, Erasmus University Rotterdam, Rotterdam, the Netherlands

5. Elseline A. Hoekzema

   Amsterdam UMC Location University of Amsterdam · Amsterdam Neuroscience · Amsterdam University Medical Centers · University of Amsterdam

   Affiliation as printed

   Department of Psychiatry, Pregnancy Brain Lab, Amsterdam Neuroscience, Amsterdam Reproduction and Development, Amsterdam University Medical Center (AUMC), location University of Amsterdam, Amsterdam, the Netherlands