With the majority of current nursing faculty approaching the decades of perimenopause or entering postmenopause,1 new information regarding cognitive function after menopause is relevant and encouraging. We know that women do not learn as well as at other times in their lives during both early and late menopause. Almost two thirds of all women report memory problems during perimenopause. However, changes are subtle and more along the lines of a decrease in cognitive improvement as opposed to an actual decline in cognitive function. Interestingly, new research reveals that a woman's learning capacity bounces back with the onset of the postmenopausal stage. Dr. Arun S. Karlamangia at UCLA's school of medicine reports, "The good news is that when women are finished with the menopause transition and in steady postmenopause, cognitive performance, memory, learning, all that comes back to premenopause levels." Dr. Victor Henderson at Stanford University's school of m adds, "For women starting the menopause transition or just finishing it, there are no big changes in memory. There may be some problems in the middle of the transition, but before and after, women are about the same."

Estrogen is known to have beneficial effects on brain function. The decline in estrogen after menopause or the fluctuations during perimenopause have often been thought to compromise brain functions. The UCLA group examined processing speed, verbal memory and working memory in 2,363 women aged 45-57 over a period of more than 4 years. Women were assessed during 4 stages of the menopausal transition: early premenopause early perimenopause; late perimenopause; and postmenopasue. The researchers noted that cognitive function did not decline in any group and actually improved in some groups, which they attributed perhaps to repeated testing. Women in late perimenopause showed less improvement in processing speed than women in the other 3 phases. Learning was also not as good in the late perimenopause when compared to the early perimenopause phase. Women in both early and late perimenopause showed fewer gains in verbal memory than those in pre- or post-menopause. Of note is that hormone therapy started before the last menstrual period seems to improve cognitive function. In contrast, hormonal therapy initiated after the last period led to smaller improvements in test scores when compared to test scores of women who did not take hormones. The study continues with researchers examining whether hot flashes or any other menopausal symptoms directly impact memory and learning ability.

Dr. Henderson added that starting hormonal therapy in women 60 to 65 years old is not going to help memory or prevent dementia or Alzheimer's. He recommends that women initiate hormonal therapy only to treat bothersome menopausal symptoms and take estrogen or progesterone for the shortest time possible at the lowest possible does. For those of us who fall in the dominant demographics for nursing faculty, this information is interesting and encouraging. We should be comforted and perhaps emboldened in knowing that our cognitive skills remain as sharp as ever.

Source: Gardner, A. Tuesday, May 26, 2009. Memory takes a hit during menopause. HealthDay. Available athttp:news.yahoo.com/s/hsn/20090526/hl_hsn/memorytakesahitduringmenopause. Accessed May 27, 2009.

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