Memory problems experienced by women as they approach and go through menopause appear to be most severe during the first stage of post-menopause, according to a new study published in the journal Menopause.
“Women going through menopausal transition have long complained of cognitive difficulties such as keeping track of information and struggling with mental tasks that would have otherwise been routine,” said lead author Miriam Weber, Ph.D., a neuropsychologist at the University of Rochester Medical Center (URMC).
“This study suggests that these problems not only exist but become most evident in women in the first year following their final menstrual period.”
For the study, researchers tracked 117 women who took a variety of tests assessing their cognitive skills. The participants reported on menopause-related symptoms such as hot flashes, sleep problems, depression and anxiety, and gave a sample of blood to determine current levels of estradiol (an indicator of estrogen levels) and follicle-stimulating hormone.
Results were analyzed to see if there were group differences in cognitive performance, and if these differences were linked to menopausal symptoms.
Participants were grouped into four stages: late reproductive, early and late menopausal transition, and early post menopause. The late reproductive period is when women first start noticing subtle changes in their menstrual periods, such as changes in flow amount or duration, but continue to have regular menstrual cycles.
Women in the transitional stage have a more noticeable fluctuation in their menstrual cycle—from a difference of seven days or more in the early phase of transition to 60 days or longer in the later phase. Hormone levels also begin to fluctuate significantly at this time, and the transition state can last for several years.
The researchers also evaluated women in early post-menopause—the first year after a woman experiences her last menstrual period.
The study participants took a comprehensive battery of tests to evaluate a variety of cognitive skills. These included tests of attention, verbal learning and memory, fine motor skills and dexterity, and working memory—the ability to not only take in and store new information, but also manipulate it.
The researchers found that women in the early stage of post-menopause performed more poorly on tests of verbal learning, verbal memory and fine motor skills than those in the late reproductive and late transition stages.
The researchers also found that sleep difficulties, depression, and anxiety did not predict memory problems. Nor could these problems be linked to specific changes in hormone levels in the blood.
“These findings suggest that cognitive declines through the transition period are independent processes rather than a consequence of sleep disruption or depression,” said Weber. “While absolute hormone levels could not be linked with cognitive function, it is possible that the fluctuations that occur during this time could play a role in the memory problems that many women experience.”
The actions of learning new information, holding on to it, and using it are functions associated with the hippocampus and prefrontal cortex—parts of the brain that are rich with estrogen receptors.
“By identifying how these memory problems progress and when women are most vulnerable, we now understand the window of opportunity during which interventions — be those therapeutic or lifestyle changes — may be beneficial,” said Weber.
“But the most important thing that women need to be reassured of is that these problems, while frustrating, are normal and, in all likelihood, temporary.”