Cognitive Troubles in Women Who Had Premature Menopause

Premature menopause may lead to poorer mental functioning later in life

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) Many women who have already had children may be pleased when they stop menstruating for good. But for women who stop a decade before 50, such premature menopause may lead to problems later on.

Senior women who went through premature menopause had more difficulty processing thoughts than other women who went through menopause later in life, a new study found.

"Discuss hormone therapy with your doctor when going through menopause."

This study was led by Dr. Joanne Ryan, a postdoctoral research fellow at Hospital La Colombiere in Montpellier, France.

The research included 4,868 women who were at least 65 years old and part of the French Three City study.

Dr. Ryan and colleagues asked the women when they had experienced menopause, defined as at least one year without menses. These researchers also asked whether menopause was due to premature ovarian failure, surgery to remove their ovaries, or another reason, such as chemotherapy.

Of the 4,868 women in the study, 2,005 had menopause after age 50. A total of 1,871 women had menopause between 46 and 50 years of age, 621 experienced menopause when they were 41 to 45 years of age, and 371 women had menopause at age 40 or earlier.

Early menopause is defined as menopause occurring between the ages of 41 and 45 years. Premature menopause is at or before age 40.

The women were also asked whether they took hormone replacement therapy, what kind, and for what length of time.

The researchers ran a variety of cognitive (thinking) tests on the women at the start of the study, and again two, four and seven years later.

While women who had gone through premature menopause did not experience dementia more than women who went through menopause later, they did have some deficits in cognitive functioning (thought processing).

There was no difference in deficits of cognitive functioning based on the reason the woman stopped menstruating (whether it was through natural ovarian failure or through surgery).

The researchers found that women who went through premature menopause had a 30 percent higher risk for a decline in psychomotor speed and global cognitive functioning seven years after the study started compared to the women who had menopause later on.

Psychomotor speed is how fast a person performs an action automatically. For example, psychomotor speed would measure how quickly a person moved away from a hot burner or put on the brakes when someone walked in front of their car.

Global cognitive functioning is an overall picture of cognitive functioning.

Hormone treatment at the time of premature menopause appeared beneficial for later-life visual memory, which is memory based on something seen, such as remembering what you had for dinner two nights ago. However, hormone treatment increased the risk of poor verbal fluency, such as being able to name many words starting with the letter "F" in 60 seconds.

Women who had premature menopause were 40 percent more likely to do poorly when performing tasks of verbal fluency or visual memory than women who had menopause at age 50 or later.

Dr. Ryan and colleagues suggested that the loss of estrogen experienced by women in premature menopause may account for some of the cognitive changes, but this does not explain why hormone therapy did not confer much benefit. These authors also noted that women have faster brain atrophy (wasting away or decrease in size) after menopause.

"Our results add to the current literature providing evidence that both premature surgical menopause and premature ovarian failure can have long-lasting negative effects on cognitive function in later life," the authors wrote.

“In terms of surgical menopause, these results suggest that further caution should be used when recommending ovariectomy in younger women, and the potential long-term effects on cognitive function are a component of the risk/benefit ratio associated with such surgery," they wrote.

Andre F. Hall, MD, of Birth and Women’s Care in Fayetteville, North Carolina, told dailyRx News that "hormonal balance is important through the various stages of life. Menopause, while unavoidable, is best dealt with when it occurs between the ages of 45-55. As cognitive function is affected by the loss of hormones during menopause, this seems to be accelerated when it occurs prematurely."

Dr. Hall added that "while prescribed hormones and other medications assist in this regard, they also have their own set of side effects. Consequently, wherever possible physicians and patients should work together to decrease the likelihood of premature menopause."

This study appeared online May 7 in the British Journal of Obstetrics and Gynaecology.

The authors declared no conflicts of interest.

Review Date: 
May 9, 2014
Last Updated:
May 12, 2014