Exercise and Brain Health in Menopause

Your brain health matters in menopause too

When we talk about menopause, we often focus on symptoms such as hot flushes, sleep disruption, mood changes and changes in body composition.

But menopause is also a significant neurological transition.

A new review looking at exercise and brain health in postmenopausal women brings together evidence from 165 studies examining how physical activity may influence memory, attention, executive function and longer-term brain health.

The reason this matters is that falling oestrogen levels affect far more than our reproductive system.

Oestrogen is involved in processes including brain energy metabolism, communication between brain cells, blood flow and neuroplasticity.

During and after menopause, changes in these systems may contribute to the memory lapses, difficulty concentrating and “brain fog” that many women experience.

So, can exercise help?

The evidence reviewed suggests yes – potentially in several ways.

Regular exercise was associated with improvements in:

• Executive function – things such as planning, focus, decision-making and working memory• Memory and attention• Overall cognitive function

Exercise was also associated with beneficial changes in brain blood flow, insulin sensitivity, inflammation and neurotrophic factors such as BDNF – a protein involved in supporting the survival and adaptability of brain cells. Some neuroimaging studies have also found exercise-related changes in areas of the brain involved in memory and cognitive control.

What type of exercise is best?

Interestingly, there isn't one clear winner.

Aerobic exercise appears particularly beneficial for cardiovascular and cerebrovascular health. Resistance training shows promising benefits for executive function, memory and maintaining aspects of brain structure. Balance, coordination and mind–body activities such as yoga may offer additional benefits.

The review suggests that a multimodal approach may provide the broadest benefits – essentially, doing more than one type of movement.

What might this look like in real life?

Rather than searching for the “perfect” brain workout, consider building a varied movement routine:

🏋️ Strength train: ideally two-three times per week.

🚶 Include aerobic exercise: walking, running, cycling, swimming or anything that challenges your cardiovascular system.

⚖️ Keep balance and coordination in the mix.

🧠 Challenge your brain as well as your body – activities involving coordination, learning new skills or dual-task exercises may provide an additional stimulus.

🪑 Try to reduce prolonged periods of sitting by building more movement into your day.

The review points towards moderate-intensity exercise programmes lasting at least 12 weeks, with sessions of around 45–60 minutes performed 3–5 times per week as a reasonable guide. However, the authors are clear that this is not a one-size-fits-all prescription and should be adapted to fitness, health, menopausal stage and individual circumstances.

And importantly, this research does not prove that exercise prevents Alzheimer's disease or dementia.

The studies are varied, and we still need larger, longer-term trials before we can say exactly what type, dose and timing of exercise is optimal – or whether exercise can definitively prevent neurodegenerative disease.

But the findings add to an increasingly compelling picture:

Exercise is not just about weight, fitness or how we look.

For women moving through and beyond menopause, staying physically active may also be one of the practical ways we can support our cognitive function and brain health as we age.

And perhaps that's the most important takeaway.

We cannot control every aspect of ageing, but maintaining strength, fitness, cardiovascular health and regular movement gives us the opportunity to positively influence several of the factors that are associated with healthy brain ageing.

Train for your future self – not just your current one.

Based on: Flynn AM et al. (2026). Exercise and Brain Health in Postmenopausal Women: A Review of Cognitive Benefits, Mechanisms, and Neurodegeneration Prevention. NeuroSci, 7(4), 90.