Hostname: page-component-76d6cb85b7-lcgwf Total loading time: 0 Render date: 2026-07-15T08:17:42.738Z Has data issue: false hasContentIssue false
  • English
  • Français

Response to interpreting cross-sectional comparisons of menopausal status and brain outcomes

Published online by Cambridge University Press:  13 July 2026

Katharina Zühlsdorff Open the ORCID record for Katharina Zühlsdorff [Opens in a new window] ,
Christelle Langley Open the ORCID record for Christelle Langley [Opens in a new window] ,
Richard Bethlehem Open the ORCID record for Richard Bethlehem [Opens in a new window] ,
Varun Warrier Open the ORCID record for Varun Warrier [Opens in a new window] ,
Rafael Romero Garcia Open the ORCID record for Rafael Romero Garcia [Opens in a new window]  and
Barbara J. Sahakian Open the ORCID record for Barbara J. Sahakian [Opens in a new window]
Katharina Zühlsdorff
Affiliation:
Department of Psychology, University of Cambridge, Cambridge, UK
Christelle Langley
Affiliation:
Department of Psychiatry, University of Cambridge, Cambridge, UK
Richard Bethlehem
Affiliation:
Department of Psychology, University of Cambridge, Cambridge, UK
Varun Warrier
Affiliation:
Department of Psychology, University of Cambridge, Cambridge, UK
Rafael Romero Garcia
Affiliation:
Department of Psychology, University of Cambridge, Cambridge, UK Instituto de Biomedicina de Sevilla (IBiS) HUVR/CSIC/CIBERSAM, ISCIII, Department of Medical Physiology and Biophysics, University of Seville, Seville, Spain
Barbara J. Sahakian*
Affiliation:
Department of Psychiatry, University of Cambridge, Cambridge, UK
*
Corresponding author: Barbara J. Sahakian; Email: bjs1001@cam.ac.uk
Rights & Permissions [Opens in a new window]

Abstract

An abstract is not available for this content. As you have access to this content, full HTML content is provided on this page. A PDF of this content is also available in through the ‘Save PDF’ action button.

Information

Type
Letter to the Editor
Information
Psychological Medicine , Volume 56 , 2026 , e226
Check for updates
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Copyright
© The Author(s), 2026. Published by Cambridge University Press

Dear Editor-in-Chief,

We thank Catriona Keye (Reference Keye2026) for acknowledging the fact that this is the first study to investigate the effects of menopause and hormone replacement therapy (HRT) on mental health, cognition, and brain structure in a very large sample of women (n = 124,780 and n = 10,873 for neuroimaging) (Zühlsdorff et al., Reference Zuhlsdorff, Langley, Bethlehem, Warrier, Garcia and Sahakian2026). We were able to conduct this study because of the high-quality, extensive measures, including mental health and neuroimaging, in a large population of women in the UK Biobank, which provides a unique and very valuable resource of data.

We did not state in our article that the study findings were causal, but that they were associations.

In addition, in our article, we did note as a limitation that our design was cross-sectional and not longitudinal. We hope to conduct a longitudinal study when data for similarly large numbers of women are available to do so. However, the UK Biobank data start at age 40 years, and neuroimaging was not conducted at baseline.

We fully agree with Catriona Keye that further research is needed to determine all the factors influencing menopause and women’s mental health, and indeed we point to some of these factors, such as genetic predispositions and comorbidities, in the discussion section of our article.

Yours sincerely,

Katharina Zühlsdorff, Christelle Langley, Richard Bethlehem, Varun Warrier, Rafael Romero Garcia, and Barbara J. Sahakian

References

Keye, C. (2026). Interpreting cross-sectional comparisons of menopausal status and brain outcomes: Letter re: Emotional and cognitive effects of menopause and hormone replacement therapy. Psychological Medicine 56, e95. https://doi.org/10.1017/S0033291726104073CrossRefGoogle Scholar
Zuhlsdorff, K., Langley, C., Bethlehem, R., Warrier, V., Garcia, R. R., & Sahakian, B. J. (2026). Emotional and cognitive effects of menopause and hormone replacement therapy. Psychological Medicine 56, e24. https://doi.org/10.1017/S0033291725102845CrossRefGoogle ScholarPubMed