Menopause and brain aneurysms: what the new figures tell us, and what we still don't know
For World Menopause Day on 18 October, we're returning to a question we raised last year: How does menopause affect the risk of a brain aneurysm?
New research has prompted us to look again at what this could mean for women in our community.
New brain aneurysm research
A major study published in The Lancet Neurology this September pooled data from 162 studies and more than 316,000 people. It found that the number of healthy adults with an unruptured brain aneurysm has more than doubled over the past two decades, from 2.9% to 6.6%. That is about one in 15 adults.
The researchers asked whether better scanning or an older population could explain the rise. Neither fully does, and they think other, as yet unknown, factors are involved.
It also found that women were affected more often than men: 5.5% of women in the study had an unruptured brain aneurysm, compared with 3% of men.
These figures may be worrying to read, especially if you already live with an aneurysm, but it’s worth remembering the vast majority of aneurysms never rupture, and the researchers say most people who have one will not need surgery.
Where menopause affects brain aneurysms
Women are about 1.5 times more likely than men to develop a brain aneurysm. After menopause, that rises to around 2.2 times.
We don't yet fully understand why. One theory is that oestrogen helps keep blood vessels flexible. When levels drop, the vessels may be less able to cope. Inflammation may also play a part.
Researchers are looking at genetics too, particularly for women with a family history.
Some researchers now think the risk for women during and after menopause could be higher than first thought.
There is still very little advice for women at this stage of life, and too little research to answer their questions. It can be frustrating to look for information about your own health and find that so much is still unknown.
Brain aneurysm research we support
At HBA Support, we support research into aneurysm risk, including the differences between women and men.
The ROAR study (Risk of Aneurysm Rupture) is the largest study of its kind in the world, following around 20,000 people with unruptured brain aneurysms. It is working to build better ways to predict which aneurysms are most likely to rupture, including things like sex and family history that current tools don't account for.
ROAR-DNA is a world-first UK study looking at the genetics of brain aneurysms. It could help show who is most at risk, and lay the groundwork for more personalised screening in future.
Women's health research and policy
If women face a higher risk after menopause, research and care need to take that into account. Women need information they can use when talking to their doctors. We want this inequality to be understood and included in the policies that shape their care.
Our policy work highlights this inequality, including our recent response to the Cardiovascular Modern Services Framework: Brain aneurysms missing from NHS framework We argued, perimenopause and menopause are critical windows for cardiovascular assessment, yet these vulnerabilities are not recognised within the current NHS framework.
The team at HBA Support continues to work hard to shine a light on an issue that urgently deserves greater research, understanding and policy attention. We believe women going through the menopause need better recognition, support and informed care, and we are committed to advocating for that change.
If you are worried
If you have a family history of brain aneurysms, or you are going through menopause and have concerns, please talk to your GP. You can also get in touch with us at HBA Support if you would like to talk about what is worrying you.
Further Reading
If you’d like to learn more about the connection between menopause and brain aneurysms, here is some academic research you may like to read:
