INS and Anxiety: During the menopause transition, women were found to experience cerebral decreases in white matter, glucose metabolism, and increases in cerebral blood flow and Aβ load. Metabolism shifted to fatty acid utilization, possibly exacerbated by growing insulin resistance. Cognition was not affected during this transition, suggesting compensatory mechanisms occurring as a response to HPO axis dysregulation (44). Mouse models of menopause using OVX mice found a decrease in acetylcholine neuron density, an increase in anxiety, Aβ load, and decrease in locomotion (161).