Effects of the Menopause Transition and Hormone Use on Cognitive Performance in Midlife Women

Many women come to me with complaints of impaired memory or "fuzzy thinking" during the peri-menopause (the period of time prior to the cessation of menses). As it turns out, until recently very few studies have been published assessing the change in cognitive function as women go through the menopausal transition. A study was published in the journal Neurology that evaluates the change in cognitive functioning women experience throughout the menopause transition and the effect hormone therapy has on altering the deterioration.

2,362 women between the ages of 42 and 53 were monitored for four years throughout their menopausal transition in the Study of Women's Health Across the Nation. Women were categorized into groups according to the time spent in the menopause transition, hormone use prior to the last menses and hormone therapy initiated after the last menstrual flow. Assessment of three types of cognitive functioning included processing speed, verbal memory and working memory.

The results were as follows:
1. Women do experience memory impairment (demonstrated as not being able to learn as well as during the pre-menopausal period) during the menopause transition
2. Once women were through the menopausal transition their memory impairment corrected to a pre-menopausal level suggesting the cognitive changes during the menopause transition are temporary
3. Women who took hormone therapy prior to their last menses had a beneficial effect on memory retention
4. Women who started hormone therapy after their final natural menses did not experience a beneficial effect and even proved to be detrimental their cognitive performance

In brief: cognitive function declined during the peri-menopause but hormone therapy started before a woman's last menstrual flow prevented the decline in function.

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Study Reference: Greendale GA, Huang M-H, Wight RG, et al. Effects of the menopause transition and hormone use on cognitive performance in midlife women. Neurology 2009;72:1850-7.

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