Menopause has no lasting impact on cognition, research finds

Common menopause symptoms such as brain fog and memory problems do not appear to have a lasting impact on cognitive performance, a study suggests.

The study found that while brain fog is a real symptom commonly experienced by perimenopausal and post-menopausal women, there is no evidence that it has an ongoing impact on core cognitive abilities such as memory, attention, problem-solving and decision-making.

Menopause usually happens at about 51, and cognitive symptoms such as forgetfulness and brain fog, including memory lapses, mental slowing and attention difficulties, are reported by 40 to 80 per cent of women.

But findings have been mixed on whether those symptoms are directly linked to cognitive performance. Their biological basis also remains unclear.

Dr Laura Naysmith, postdoctoral research associate at King’s College London and the study’s first author, said: “Cognitive symptoms are very real and often quite a distressing aspect of the menopause.”

“While mental effort [may] need to increase to maintain cognitive function due to these symptoms, we hope it is reassuring to those experiencing symptoms that cognitive abilities can be preserved.”

“Our study found that core cognitive abilities are consistent between menopausal stages.”

Researchers analysed data from 14,234 women aged 45 to 55 in the REACT-Long Covid Study, a large community cohort in England.

Participants were divided into three groups by menopausal stage, pre-menopause, perimenopause and post-menopause, and reported cognitive symptoms before completing eight online tasks designed to test memory and reasoning.

The analysis found only minimal differences in overall cognitive performance across the three groups, with cognitive symptoms only weakly linked to performance in pre-menopause, perimenopause and post-menopause.

The researchers did find a very weak link between symptoms and performance, but further analysis suggested that cognitive symptoms were more closely associated with increased reporting of psychological symptoms, including anxiety and low mood, especially among perimenopausal and post-menopausal participants.

The team said no global cognitive dysfunction was seen, but stressed that the reported symptoms can still have a significant effect on quality of life.

They called for more precise measures of subjective cognitive difficulties in future research.

Adam Hampshire, the study’s senior author, said: “Next we will explore the basis of the observed elevation in cognitive symptoms in more detail, including whether specific aspects of cognitive performance, or particular groups of people with certain symptom profiles or HRT [hormone-replacement therapy] use, show clearer differences.”