New research from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King's College London has found no evidence that the transitional symptoms of menopause such as brain fog and memory problems have a lasting impact on cognitive performance.
The research, published in NPJ Women's Health, found that while brain fog is a real symptom commonly experienced by peri- and postmenopausal women, there is no evidence that it has an ongoing impact on a person's cognitive abilities.
Menopause spontaneously occurs at an average age of 51 in women, with cognitive difficulty like forgetfulness and 'brain fog' (i.e. memory lapses, mental slowing, or attention difficulties) reportedly occurring in anywhere from 40 to 80 per cent of women. While the biological basis for these symptoms has not yet been fully explained, there are contradictory findings on whether cognitive symptoms relate directly to performance.
In this study, 14,234 women aged 45-55 from the REACT-Long Covid Study were split into three groups depending on their menopausal experience (pre-, peri- and post-menopause) and self reported cognitive symptoms of menopause before undertaking eight online tasks designed to test memory and reasoning.
An initial analysis of the data established that overall cognitive performance differed minimally across the three groups, with cognitive symptoms only weakly associated with cognitive performance in the pre-, peri- and postmenopausal stages.
While the researchers did find a very weak link between symptoms and abilities, further analysis showed that the experience of cognitive symptoms was more closely correlated with an increased reporting of psychological symptoms, including anxiety and low mood, especially in peri- and postmenopausal participants.
"Cognitive symptoms are very real and often quite a distressing aspect of the menopause. While transient, feelings of forgetfulness or mental slowing can be strongly felt and have a significant impact on a person's day to day life."
Dr Laura Naysmith, Postdoctoral Research Associate at King's IoPPN and the study's first author
Dr Laura Naysmith, Postdoctoral Research Associate at King's IoPPN and the study's first author said, "Our study found that core cognitive abilities are consistent between menopausal stages. While the mental effort will need to increase to maintain cognitive function due to these symptoms, we hope it is reassuring to those experiencing symptoms that cognitive abilities can be preserved, even when the experience feels much more difficult."
Adam Hampshire, Professor of Cognitive and Computational Neuroscience at King's IoPPN and the study's senior author said, "These results indicate that there is not a global overall reduction in cognitive performance associated with menopause, but cognitive symptoms in daily life are elevated. Next we will explore the basis of the observed elevation in cognitive symptoms in more detail, including whether specific aspects of cognitive performance, or particular groups of people with certain symptom profiles or HRT use, show clearer differences."
Cognition and the menopause transition: Cross-sectional evidence from a large community cohort (DOI10.1038/s44294-026-00132-z.) (Naysmith, Hampshire et al) was published in NPJ Women's Health.
