The Menopausal Mind: Reframing Female Senescence as a Neuroendocrine and Metabolic Disorder

Menopause represents a complex neuroendocrine transition characterized by systemic hormonal decline, mitochondrial dysfunction, and metabolic inflexibility. This review reframes menopause not as a passive consequence of aging but as a reversible neuroendocrine disorder with identifiable metabolic roots. Mounting evidence links insulin resistance, chronic inflammation, and oxidative stress to the early onset and symptom severity of menopause. The intersection between metabolic dysfunction and hormonal senescence drives neurocognitive decline, vasomotor instability, and increased cardiometabolic risk. Translational research suggests that nutritional and lifestyle strategies—especially those inducing ketosis—can restore energy homeostasis, enhance cognitive resilience, and attenuate menopausal symptoms. This article integrates endocrinologic, neurologic, and metabolic data to propose a root-cause approach that moves beyond hormone replacement alone toward comprehensive metabolic restoration.