Early menopause may trigger cognitive decline

Women who experience premature menopause either due to surgical treatment or reproductive organ failure may have a higher risk of cognitive problems later in life, according to a large, multisite study in France published May 7 in the international journal of obstetrics and gynecology, BJOG.

The study included 4,868 women from three French cities and included cognitive tests and clinical dementia diagnosis at the beginning of the study and at the two, four and seven-year marks to gauge how early menopause affects later cognition and whether hormone therapy ameliorates those effects.

Results of the study showed that women who reached menopause at or around 40 scored lower cognitively than others who became menopausal at or after the age of 50. Premature menopause was associated with a 40 percent increased risk of poor performance in visual memory and verbal fluency and a 35 percent increased risk of slower psychomotor speed. However early menopause was not seen as a major predictor of dementia.

Of the 4,868 subjects, 79 percent experienced natural menopause, or ovarian failure; 10 percent had undergone surgery; and 11 percent went into menopause for other reasons, including drug and radiation therapy. More than a fifth of subjects underwent hormone treatment at menopause. The results of the study revealed that hormones may benefit visual memory, but did not improve the decline in verbal fluency.

The study was co-authored by Joanne Ryan, a postdoctoral research fellow in neuropsychiatry, epidemiological and clinical research at the Hospital La Colombiere, in Montpellier, France. “Both premature surgical menopause and premature ovarian failure, were associated with long-term negative effects on cognitive function, which are not entirely offset by menopausal hormone treatment,” explained Ryan in a BJOG blog post about the study.

The authors concluded that the findings of this study should be taken into account when making decisions about ovariectomy in premenopausal patients. The results could inform clinicians performing cognitive testing and associated imaging for prematurely menopausal women.