The Mind at Menopause
Estrogen fluctuations may compromise cognitive abilities, temporarily

(HealthDay News) -- It's not your imagination: If you're a woman in menopause, you may be experiencing subtle deficits in memory and learning. The good news is that any changes should be temporary. Cognitive function returns to normal in postmenopause, researchers at the David Geffen School of Medicine at the University of California, Los Angeles, reported in the journal Neurology. "For women starting the menopause transition or just finishing it, there are no big changes in memory," Dr. Victor Henderson, a professor of health research and policy and of neurology and neurological sciences at Stanford University School of Medicine, and past president of the North American Menopause Society, told HealthDay. "There may be some problems in the middle of the transition, but before and after, women are about the same," he said. Menopause marks the end of a woman's fertility and results in lower levels of estrogen and other hormones, according to the society. Menopause occurs, on average, at age 51, but women typically experience physical signs of menopause many years before their final menstrual period, it says. During the transition to menopause, called perimenopause, estrogen levels begin to decline, the society explains. A woman may experience irregular menstrual periods, hot flashes, sleep disturbances, mood swings, low sex drive and vaginal dryness. Almost two-thirds of women report memory problems, researchers say. But are these perceived difficulties real? UCLA researchers studied 2,362 women, aged 42 to 52, over a four-year period. All had at least one menstrual period in the three months before the start of the study. The team measured the women's performance throughout the menopause transition, using tests of verbal memory, working memory and processing speed. Processing speed improved with repeated testing during premenopause, early perimenopause and postmenopause. But women in late perimenopause showed less improvement than the other groups, the study found. On verbal memory performance, improvement was not as strong during early and late perimenopause, compared with premenopause. So would hormone therapy help? Yes and no. The study found that taking estrogen or progesterone before menopause helped verbal memory and processing speed. But women who started hormones after their final menstrual period showed no improvement in processing speed or verbal memory. "Our results suggest that the critical period for estrogen or progesterone's benefits on the brain may be prior to menopause, but the findings should be interpreted with caution," the study's lead investigator, Dr. Gail Greendale, a professor in the division of geriatrics at the UCLA medical school, said in a prepared statement. A recent paper in the Journal of Neuroscience seems to support that observation. In a study on mice, Karyn M. Frick, an associate professor of psychology at Yale University, and her colleagues examined a particular cell-signaling pathway in an area of the brain critical to learning and memory. Estrogen activated this pathway and improved the ability of middle-aged female mice to recall objects but had no effect on memory or cell signaling in older female mice. For women who are concerned about declining cognitive performance, though, the Menopause Society recommends consulting a health care professional. Remaining physically, socially and mentally active, though, might help prevent memory loss, it adds.

On the Web

To learn more about menopause, visit the U.S. National Institute on Aging.

SOURCES: HealthDay News; Victor Henderson, M.D., professor, health research and policy, neurology and neurological sciences, Stanford University School of Medicine, Stanford, Calif.; May 26, 2009, Neurology; University of California, Los Angeles, news release, May 27, 2009; Yale University, news release, March 23, 2010; North American Menopause Society (www.menopause.org)
Author: Karen Pallarito
Publication Date: May 31, 2010
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