How Puberty, Pregnancy, and Menopause Change the Brain

Level: C1

Printable: Student handout (PDF) | Teacher’s key (PDF)

Reading

Tell people that a woman’s brain has lost gray matter, and most will imagine damage or decline. The evidence points to something more counterintuitive. Gray matter, the tissue packed with nerve cell bodies that forms most of the brain’s wrinkled outer layer, shrinks noticeably during at least two healthy stages of female life: puberty and pregnancy. Both stages bring large shifts in the sex hormones estrogen and progesterone, which act on receptors found throughout the brain. Menopause seems to follow a different rule. Together, these findings raise a question with no simple answer: when does a smaller brain mean a worse one?

The clearest case is adolescence, when both girls and boys lose gray matter, a change widely thought to reflect pruning: the brain removes connections it rarely uses so that the ones it uses often can work more efficiently. This explanation rests mainly on imaging and animal research, not on direct counts of connections in living teenagers. In girls, the loss overlaps with the hormonal surge around the first menstrual period.

Pregnancy produces a similar pattern. In a longitudinal study published in Nature Neuroscience in 2017, a team from Barcelona and Leiden led by Elseline Hoekzema scanned 25 women before and after their first pregnancy. The mothers lost gray matter in regions linked to social cognition, the ability to understand what other people think and feel, and the losses were still visible two years after birth. The changes were consistent enough for a computer program to identify, from the scans alone, which women had been pregnant. In 2024, a US team led by Laura Pritschet scanned one first-time mother 26 times before, during, and after her pregnancy. Gray matter fell by an average of about 4 percent in roughly 80 percent of the regions measured, while white matter, the brain’s connecting fibers, briefly became more robust before returning to its baseline after birth. With only one person scanned, the result shows what can happen, not what usually happens.

A 2026 study in Nature Communications, led by Sophie van ‘t Hof at Amsterdam University Medical Center, compared all three transitions with a single method, following each woman over time. It used one cohort for each transition, 1,095 women in total. Girls going through their first period lost cortical gray matter at an accelerated rate, about 0.16 percent a month, and women in a first or second pregnancy lost about 0.12 percent a month; comparison groups not in transition showed no such speed-up. Van ‘t Hof calls her team’s interpretation a hypothesis: they see the loss as adaptive fine-tuning, not harm. She has also stressed that less gray matter is not a memory complaint, and that, as of 2026, research had not linked the pregnancy changes to so-called “mommy brain.”

Menopause did not fit this pattern. Using UK Biobank data, the team compared 120 women who passed through the transition during the study with women before or after it. The stable groups lost gray matter at the slow rate expected with age, about 0.03 percent a month. The women in transition showed no detectable loss, as if ordinary aging had paused. This does not match all earlier work. In 2021, Lisa Mosconi’s team in New York reported a transient dip in gray matter in at least one region, the precuneus, which recovered after menopause, along with increases in blood flow and cellular energy production that looked compensatory. One possible reason for the discrepancy is design: Mosconi’s team examined specific regions and compared women at different stages, while the Amsterdam team tracked total gray matter within the same women.

The Amsterdam team lacked directly measured hormone data for every group, so the role of estrogen and progesterone is inferred rather than shown to be causal. Menopause status was self-reported, the groups were scanned on different machines, and every study described here is observational: researchers recorded changes rather than controlling them. Commenting for Spain’s Science Media Centre, the biomedical researcher Nuria Marín Jiménez noted that structural changes do not, on their own, show that a brain works better or worse.

These questions are still open partly because female biology has long been overlooked in brain research. A survey by Liisa Galea’s group at the University of British Columbia, published in 2022, examined more than 3,000 neuroscience and psychiatry papers and found that in 2019 only 5 percent analyzed sex as a factor that might explain their results. With so little earlier work to compare against, the menopause finding is preliminary, and its authors have said they cannot explain the pause. The next test is scale: the Maternal Brain Project, described in 2024 by the team behind the single-case study, aims to scan hundreds of women and could show whether these changes predict memory or mood after birth.

Vocabulary

Each word has a frequency score, a rank, and a tag. The score shows how common the word is in modern English: higher means more common, and each full point means roughly ten times more common. The rank is the word’s position on a list of about 321,000 English word forms, from most to least common. The tag shows where you are most likely to meet the word: Current, Formal, Literary, or Dated. The paragraph number shows where the word first appears in the reading. The labels are information, not instructions. Deciding which words are worth your time is up to you. How to read the scores, ranks, and tags.

It is counterintuitive that healthy brains lose gray matter during puberty and pregnancy.
It is counterintuitive, but adding more lanes to a busy road can make traffic worse over time.

Estrogen and progesterone act on receptors found throughout the brain.
Some allergy medications work by blocking receptors in the nose and throat.

Gray matter loss in teenagers is widely thought to reflect the pruning of rarely used connections.
The gardener spent the afternoon pruning the overgrown rose bushes.

In girls, gray matter loss overlaps with the hormonal surge around the first period.
There is always a surge in train bookings just before the holidays.

Hoekzema’s longitudinal study scanned the same women before and after their first pregnancy.
The school ran a longitudinal survey, tracking the same students from age five to eighteen.

White matter became more robust during pregnancy and then returned to its baseline after birth.
Measure your resting heart rate for a week to set a baseline before you start training.

The 2026 study used one cohort of women for each hormonal transition.
Doctors tracked a cohort of smokers for twenty years to study lung disease.

Girls going through their first period lost gray matter at an accelerated rate.
The city’s population growth has accelerated sharply since the new factory opened.

Van ‘t Hof’s team sees the loss as adaptive fine-tuning rather than harm.
Sweating is an adaptive response that helps the body cool down.

Mosconi’s team reported a transient dip in gray matter that recovered after menopause.
The headache was transient and disappeared within an hour.

Increases in blood flow during menopause looked compensatory to Mosconi’s team.
After losing sight in one eye, she developed compensatory habits, such as turning her head more often.

One possible reason for the discrepancy between the two menopause studies is their design.
The bank found a discrepancy between my receipt and the amount charged to my card.

Without hormone data for every group, the role of hormones cannot be shown to be causal.
Scientists ran a controlled experiment to test whether the drug had a causal effect.

Female biology has long been overlooked in brain research.
Small safety problems are often overlooked until something goes wrong.

With little earlier work to compare against, the menopause finding is preliminary.
These are preliminary results; the final report will not appear for months.

Activity Page

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Speed Challenge

Answer 12 questions against the clock. Every wrong answer adds 5 seconds, and the lowest score wins. Open the speed challenge in a new tab.

Shadow Reading and Typing: Reading About My Own Brain

This short text uses many of the words from this lesson. Use it for shadow reading (reading aloud along with a model) and for typing practice.

A few months after my daughter was born, I kept losing my keys, and my friends joked that I had mommy brain. So I started reading about pregnancy and the brain. What I found was more counterintuitive than I expected. Healthy women appear to lose some gray matter during pregnancy, just as teenagers do during puberty.

At first, this frightened me. Then I read that scientists often explain the teenage loss as pruning, a way of removing connections the brain rarely uses. Some researchers suspect that pregnancy involves similar adaptive fine tuning. It may be linked to a hormonal surge acting on receptors in the brain. It is a hypothesis, not a settled fact, but it changed how I felt.

I also learned why the evidence is still limited. The strongest findings come from longitudinal studies that compare each woman with her own baseline. One recent cohort study found that gray matter loss was accelerated during first pregnancies. In another study of a single mother, a change in white matter proved transient. Because these studies are observational, they cannot show a causal link between hormones and the changes.

Surprisingly, female biology has long been overlooked in brain research. Studies of menopause even show a discrepancy. One team saw possible compensatory changes, while another saw almost no loss. Since the findings are preliminary, I try not to read too much into them. As far as I know, nobody has shown that these changes explain my lost keys, which is oddly comforting.

How to practice

Read the text silently once and check any words you are unsure of.
Read it aloud slowly, one sentence at a time. On the typing page, the Listen button reads each line with your device’s voice, so you can listen first and then repeat.
Shadow: read aloud again at a natural speed, trying to keep a steady rhythm without stopping.
Record yourself, listen back, and note one sentence to practice again.
Type it on the typing page below and check your speed and accuracy.

Open the typing practice in a new tab

Comprehension Questions

What common assumption does the writer question in the first paragraph?
What is pruning, and why is it thought to be useful?
What did Hoekzema’s team find in first-time mothers, and how long did the changes last?
How did white matter change in the 2024 single-case study?
What was new about the design of the 2026 Amsterdam study?
How did menopause differ from puberty and pregnancy in the 2026 study?
What reason does the writer give for the discrepancy between the Amsterdam and Mosconi findings, and how certain is it?
Why is the role of hormones described as inferred rather than causal, and what other limits does the writer mention?
Why do you think the writer ends with the Maternal Brain Project instead of a conclusion?

IELTS-Style Questions

True, False, or Not Given: “The Amsterdam team measured hormone levels directly in all three groups.” Explain your answer using evidence from the reading.
Yes, No, or Not Given: “The writer believes that a smaller brain is always a worse brain.” Explain your answer using evidence from the reading.
Author’s purpose: Why does the writer include the finding from Galea’s survey in the last paragraph?

AI Discussion Prompt

I just read an article about whether losing gray matter always means a brain is getting worse. It described gray matter loss during puberty, thought to reflect pruning; studies from 2017 and 2024 showing lasting gray matter loss during pregnancy; a 2026 Amsterdam study of 1,095 women that found accelerated loss in puberty and pregnancy but a pause in normal age-related loss during menopause; a 2021 menopause study with different results; the limits of this research; and how rarely brain studies analyze sex. I am an English learner at about C1 level. Please ask me one question at a time, starting with what surprised me. Respond to my ideas first, then briefly correct any language errors, and challenge my assumptions when it is useful.

AI Vocabulary Prompt

I want to practice vocabulary from an article about how the female brain changes during puberty, pregnancy, and menopause. Please quiz me on the following words one at a time, using a mix of question types: multiple choice, true/false, and sentence completion. Give me feedback after each answer before moving on, and bring back the words I miss later. Here are the words: counterintuitive, receptors, pruning, surge, longitudinal, baseline, cohort, accelerated, adaptive, transient, compensatory, discrepancy, causal, overlooked, preliminary.

Discussion Questions

Before reading this, what did you think happened to the brain as people grow older?
Which finding in the reading did you find most unexpected?
When you hear the word “loss,” do you usually think of something negative? Can you think of a loss that is useful?
In your culture, how openly do people talk about puberty, pregnancy, or menopause?
Many people joke about “mommy brain.” Why might ideas like this spread even when the evidence is limited?
How much weight should a study of one person carry? What would convince you that a finding applies to most people?
Why do you think female biology has been studied less than male biology in brain research?
Should research funders require studies to analyze sex as a factor? What might the costs be?
How should journalists report early findings like these so that readers are informed but not misled?
If your own brain were changing in a major way, would you want to know the details? Why or why not?
Should schools teach teenagers that their brains are still changing? How might that knowledge affect them?
Should workplaces offer support to employees going through menopause? What might that support look like?
The reading calls some brain changes possibly “adaptive.” Who decides what counts as normal or healthy when bodies change?
Can science describe differences between groups of people without those findings being used to limit them? How?

Language Focus: Reduced relative clauses (participle phrases after nouns)

What it is: A reduced relative clause is a relative clause shortened to a participle phrase. “Regions that are linked to” becomes “regions linked to” (past participle, passive meaning). “Girls who are going through” becomes “girls going through” (-ing participle, active meaning).

Why writers use it: Scientific and news writing uses reduced relative clauses to add detail to a noun without a full clause. Recognizing them helps you find the main verb in long sentences, and using them makes your own writing more concise.

Examples from the reading:

“Gray matter, the tissue packed with nerve cell bodies that forms most of the brain’s wrinkled outer layer, shrinks noticeably…”
“…which act on receptors found throughout the brain.”
“The mothers lost gray matter in regions linked to social cognition…”
“Girls going through their first period lost cortical gray matter at an accelerated rate…”

Practice task: Reduce the relative clauses: “The hormones that are produced during pregnancy affect many organs. Researchers who are studying menopause want larger samples.”

(Example answer: “The hormones produced during pregnancy affect many organs. Researchers studying menopause want larger samples.”)

Recommended Resources

Brain Shrinkage Tied to Aging ‘Pauses’ as a Woman Nears Menopause, Study Finds (Live Science). A short news report on the 2026 study, with the lead researcher explaining what gray matter loss does and does not mean.
Neuroscience: Brain Changes in Menopause Are Distinct From Puberty and Pregnancy (Nature Portfolio press release). The publisher’s brief summary of the 2026 study, with group sizes and the limits the authors name.
Pregnancy Causes Lasting Changes in a Woman’s Brain (Scientific American). An accessible report on the 2017 Barcelona and Leiden study of first-time mothers.
Scientists Shed Light on the Many Ways Women’s Brains Change During Pregnancy (Euronews). A news report on the 2024 study that scanned one woman 26 times before, during, and after her pregnancy.
Imaging Study Reveals Brain Changes During the Transition to Menopause (Weill Cornell Medicine). The university’s summary of Lisa Mosconi’s 2021 study, including signs of recovery after menopause.