The menopause: How does it impact mental and cognitive function?

Independent

07-03-2025

Menopausal symptoms may be linked to increased risk of cognitive decline, a new study suggests.
Researchers found that women reporting more intense menopausal symptoms also experienced greater difficulties with thinking, learning, and memory later in life.
The study, published in PLOS One, involved 896 post-menopausal women with an average age of 64.
Participants rated the severity of 11 common menopausal symptoms, including hot flashes, brain fog, and mood swings, on a scale of zero to 10.
Canadian researchers discovered a correlation between higher symptom scores and reported cognitive difficulties.
Furthermore, the study indicated a link between increased menopausal symptoms and mild behavioural impairment, encompassing changes in personality, reduced motivation, and impulse control issues.
While these findings highlight the potential importance of the menopausal phase in assessing dementia risk, researchers emphasize the need for further investigation.
We've consulted experts to help explain the science behind how menopause can affect our mental and cognitive abilities…
Mood
'During perimenopause, your hormones – mainly oestrogen and progesterone – start fluctuating,' says Dr Naomi Potter, menopause specialist and founder of Menopause Care. And these hormonal shifts can take a toll on mood and mental wellbeing, as well as the body.
' Oestrogen plays a big role in brain chemicals like serotonin and dopamine, which help regulate mood,' explains Potter. 'When oestrogen levels drop, serotonin production can slow down, making you feel lower, more irritable, and more prone to anxiety.
'These ups and downs can also make emotions feel more intense, so anxiety can feel even more overwhelming during perimenopause.'
'Between 40-60% of women experience sleep disturbances during the menopause transition,' highlights Potter. 'This can be caused by hormonal changes themselves, as well as symptoms like hot flushes, night sweats, and frequent trips to the bathroom at night.
'Poor sleep can make it harder for your body to handle stress and emotions, leading to lower tolerance, brain fog, and heightened feelings of anxiety.'
Oestrogen and testosterone play an important role in memory and cognition.
'When the levels of these hormones drop during menopause and perimenopause, it can lead to an array of symptoms including poor memory, difficulty finding words, difficulty staying focused and a feeling that the brain feels 'fuzzy' or 'cloudy',' explains Dr Angela Rai, GP at The London General Practice. 'This is often described as 'brain fog'.'
Longer-term issues
Some women experience symptoms of depression during menopause.
Unlike temporary mood swings or the worry that comes with anxiety, depression is more persistent, affecting emotions, behaviour, and daily life in a way that doesn't just pass with time, highlights Potter.
'Depressive symptoms are most common during perimenopause – the transition leading up to menopause – when hormone fluctuations are at their peak,' explains Potter. 'This makes it a particularly vulnerable time, so it's important to stay aware of changes in mood and wellbeing during these years.
'While less common, depression can also develop later in menopause, though more research is needed to fully understand why.'
What advice would you give to women who are experiencing mental or cognitive impacts from menopause?
Seek professional advice
'Even mild emotional or psychological struggles during menopause are a valid reason to seek support,' says Potter. 'There's absolutely no shame in talking to a doctor – no one should have to suffer through menopausal symptoms alone.'
Look into medication options for specific symptoms
'Beta-blockers, such as propranolol, can help with the physical effects of anxiety, like a racing heartbeat, flushing, and shaking, by blocking certain stress-related chemicals in the brain,' says Potter.
'Whereas medications like selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) can help regulate mood by increasing levels of serotonin and dopamine, often referred to as the brain's 'happy hormones'.'
Exercise regularly
'Staying active is one of the most effective ways to boost mood,' highlights Potter. ' Studies suggest that exercise is 1.5 times more effective than medication or therapy for mild to moderate anxiety.'
Practice relaxation techniques
'Practices like mindfulness, meditation, deep breathing exercises, and menopause yoga can help manage stress and anxiety,' notes Potter. 'These techniques encourage present-moment awareness, helping to break cycles of anxious thoughts and reduce emotional reactivity, which can be heightened by hormonal fluctuations.'
Eat a healthy diet
'A well-balanced diet rich in vitamins and minerals can positively impact both physical and mental wellbeing,' adds Potter.
Lean on your support system
'Talking to friends, family, or a support group can provide emotional relief,' says Potter. 'Knowing you're not alone in your experience can be incredibly reassuring.'
Make sleep a priority
' Sleep and anxiety can create a vicious cycle, so maintaining good sleep hygiene is crucial,' stresses Potter.