What Menopause Really Does to Your Brain, with UCLA Neurologist Dr. Rhonda Voskuhl
Rosie Acosta talks with Dr. Rhonda Voskuhl, a neurologist and researcher at UCLA, about the connection between menopause and brain health—why brain fog is real, what estrogen does for the brain, and what women can do to protect their cognitive health.
What happens when the fog in midlife is on the inside—affecting memory, confidence and clarity?
Conversations about menopause often focus on hot flashes and other physical changes. In this episode, Rosie Acosta and Dr. Rhonda Voskuhl turn the focus to the brain.
Dr. Voskuhl, a neurologist, researcher at UCLA and Director of the UCLA Multiple Sclerosis Program, explains why she sees estrogen loss as a significant shift for the brain—not only the body—and why brain fog deserves to be taken seriously as a real clinical issue.
Rosie shares her own experience of feeling disregarded by the medical system, and the two discuss the gap between neurology and gynecology in women’s care, what brain imaging research is revealing, and the role of exercise and cognitive training in brain health.
The episode is an invitation to protect your brain with the same care you give the rest of your body.
Ideas explored in this conversation
- Dr. Voskuhl describes estrogen as protective for the brain and discusses how its decline may affect verbal memory.
- Brain fog is a legitimate concern that deserves clinical attention, not dismissal.
- There is often a gap between neurology and gynecology in how women’s midlife care is delivered.
- Birth control and menopausal hormone therapy serve different purposes.
- Brain imaging research is helping researchers understand how the brain changes around menopause.
- Dr. Voskuhl’s research in multiple sclerosis has explored the anti-inflammatory effects of estriol, a form of estrogen.
- Exercise and cognitive training are part of supporting brain health beyond hormones.
- Decisions about hormone therapy should be tailored to your own health history and long-term goals.
Brain fog is real
Many women describe forgetfulness, word-finding trouble and a loss of mental sharpness during perimenopause and menopause—and many are told it is just stress or aging. Dr. Voskuhl argues that these changes deserve to be taken seriously and discusses how specific cognitive changes can be identified and tracked.
Memory and concentration problems can have many causes, including sleep disruption, mood changes, medications and other medical conditions. If brain fog is affecting your daily life, it is worth raising with a healthcare provider rather than assuming it is something you simply have to live with.
Between neurology and gynecology
Rosie and Dr. Voskuhl discuss a structural problem in women’s care: the brain effects of menopause can fall between specialties. Gynecologists focus on reproductive health, neurologists on the brain, and women can be left without anyone connecting the two.
They also discuss why doctors often prescribe birth control first, how that differs from menopausal hormone therapy, and the importance of weighing risks and long-term brain health with a provider who understands your full picture.
Beyond hormones: exercise and cognitive training
Hormones are only part of the conversation. Dr. Voskuhl discusses how exercise and cognitive training can support brain health, and touches on BDNF, a protein involved in the growth and health of brain cells.
The episode closes with a look at equity and real-world impact: making sure the growing science on menopause and the brain reaches the women who need it.
Timestamps
Explore the conversation
Questions explored in this episode
Is menopause brain fog real?
Many women report forgetfulness, word-finding trouble and reduced mental sharpness around menopause. In this episode, Dr. Rhonda Voskuhl argues that brain fog deserves to be taken seriously as a clinical concern. Because memory problems can have several causes, it is worth discussing with a healthcare provider.
How does estrogen affect the brain?
Dr. Voskuhl describes estrogen as protective for the brain and discusses how its decline may affect verbal memory. Research on menopause and brain health is ongoing.
Why do doctors often prescribe birth control instead of hormone therapy?
The episode discusses how birth control is often offered first and how it differs from menopausal hormone therapy. The two serve different purposes, and the right approach depends on your age, symptoms and health history.
What is estriol?
Estriol is a form of estrogen. Dr. Voskuhl’s research in multiple sclerosis has explored its anti-inflammatory effects. Any hormone treatment should be discussed with a qualified healthcare provider.
What else can support brain health during menopause?
Beyond hormones, Dr. Voskuhl discusses exercise and cognitive training as ways to support brain health. Sleep, stress management and regular medical care also matter.
Who is Dr. Rhonda Voskuhl?
Dr. Rhonda Voskuhl is a neurologist and researcher at UCLA and Director of the UCLA Multiple Sclerosis Program, whose work focuses on neuroprotection.
Care for your mind with the same devotion you give your body.
Rosie offers mental health coaching grounded in mindfulness, self-compassion and practical tools for the emotional side of perimenopause and midlife change. Coaching complements—never replaces—care from your healthcare providers, and is available in English and Spanish.
This page summarizes topics discussed in the episode and is intended for educational purposes. It does not provide medical or mental-health advice, diagnosis or treatment. Seek qualified professional care for persistent, severe or concerning symptoms.