Menopause Symptom Severity Associated With Cognitive Performance

Unhealthy mature woman sitting on couch at home closed eyes touch head feels overheated, aged female having health problems, suffers migraine, high blood pressure, ageing process or menopause concept
The link between menopause and changes in cognitive function is a subject of debate. Researchers sought to investigate the potential association with the aim of improving womens’ health.

Cognitive performance in women is sensitive to severe depression and sexual dysfunction, researchers reported in journal Menopause.

The cross-sectional study included women from the rural areas of Punjab, North India, aged 40 to 65 years, with no known history of chronic disease, prolonged illness, or physical deformity.

The Greene Climacteric Scale was used to record the presence and intensity of 21 menopausal symptoms. The Hindi version of the Mini-Mental State Examination (MMSE), a 30-point questionnaire, was used to assess respondents’ global cognitive performance.

The analysis included 404 women (mean age, 50.78 years) with a mean age at menarche of 14.89±0.08 years and mean age at menopause of 47.24±0.32 years. A majority of the women (83.4%) were married, and 93.8% did not have any kind of private or government job. Of the cohort, 107 were premenopausal, 90 were perimenopausal, 92 were early postmenopausal, and 115 were late postmenopausal.

Late postmenopausal women had the greatest severity of menopausal symptoms— depression (67%), total psychological (60.9%), somatic (63.5%), and sexual dysfunction (67.8%). Anxiety (58.7%) and vasomotor symptoms (59.8%) were more severe in early postmenopausal women.

Women with severe menopausal symptoms according to a higher Total Greene climacteric score had significantly lower mean values for orientation (8.11 vs 8.90, P < .001), registration (2.77 vs 2.91, P < .001), attention (4.31 vs 4.48, P < .01), recall (2.26 vs 2.53, P < .05), and language/visuo-spatial skills (7.13 vs 7.91, P < .001), compared with women who had mild menopausal symptoms.

Multivariate linear regression analysis found that only severe depression and greater intensity of sexual dysfunction had a negative and significant association with MMSE scores after adjustment for age, marital status, and educational status.

Among several limitations, the cross-sectional design did not allow assessment of the causal relationship between menopausal symptoms and poor cognitive scores. Also, an objectively measured number of hot flashes instead of self-reported responses might have shown better understanding of cognitive performance, and recall bias (such as the age at menarche and menopause) was possible.

“An increase in longevity has resulted in a substantial proportion of women in their postreproductive phase for an extended period,” stated the study authors. “However, the lack of awareness of menopausal-related symptoms, absence of counseling, and adequate medical interventions often deprive them of good quality of life. Results of the present study can help rural health services to plan specific programs to tackle menopausal-related issues.”


Kaur M, Kaur M. Is cognitive performance of women sensitive to the severity of menopausal symptoms? Menopause. 2022;29(2):170-177. doi: 10.1097/GME.0000000000001910