Menopause Marks the End of Fertility and Beginning of Temporary Memory Loss and Learning Deficits

The monthly cycle begins and a woman emerges from within. Along with the attainment of womanhood come the emotional roller coaster, the bearing and rearing of children, and all the wonderful chaos that these aspects of life entail. Then, just when you think you finally have it all under control, menopause strikes! Suddenly you can’t find anything and you’re sure that an unseen being is moving and hiding your personal belongings. You forget things you knew. You can’t seem to retain new knowledge and the whole world seems to be speaking Greek.  Well, you can hold onto your sanity and breathe a sigh of relief. Although these stressful issues are very real, you haven’t permanently lost your mind as this mental state is only temporary.

Science has finally acknowledged that menopausal women experience both memory loss and learning difficulties, but also assures us that the phase suffered will pass. Research at UCLA has revealed that memory takes a hit and women do not learn as well during the stages of early and late perimenopause, a phase in which the monthly cycle becomes irregular but has not altogether ended. The report was published in the May 26th issue of Neurology.

Menopause marks the permanent cessation of reproductive fertility. The term menopause describes the reproductive change in human females, where the end of fertility is indicated by the permanent stopping of menstruation or "menses." The word "menopause" literally means the "end of monthly cycles" from the Greek words pausis (cessation) and the word root men (month). Ah, an explanation for women feeling that everyone is speaking Greek during the menopausal transition!

In their report, the researchers noted that the menopausal changes were subtle, and were more a phase of less improvement rather than actual decline. However, the deficits seen in their research was temporary. According to Dr. Arun S. Karlamangla, an associate professor of medicine at UCLA's David Geffen School of Medicine and the study's senior author, “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.”

The researchers found that nearly two-thirds of women experience memory problems during this transitional time in their lives. Since estrogen is known to boost brain function, memory and other brain functions are believed to be compromised by the decline in estrogen level that occurs after menopause or the fluctuations in hormone levels that occur during perimenopause

The research team studied 2,362 women between the ages of 45 and 57 over a period of four years. They looked at processing speed, verbal memory and working memory, which involves how quickly information is processed. Assessments were performed on the participants during four stages of the transition. These stages included premenopause in which menstrual periods remained regular, early perimenopause marked by some irregularity, late perimenopause during which periods are missed for three to 11 months and postmenopause where there no period occurs for one year.

Karlamangla explained that when cognitive performance was measured during premenopause and at the onset of menopause, the researchers were surprised to find that cognitive functioning did not decline in any group, but actually improved in all groups. However, women in late perimenopause demonstrated less improvement in processing speed than women in the other three phases. In addition, Karlamangla said that learning was not as good in the late perimenopausal stage as in the early perimenopausal phase. He also noted that both early and late perimenopausal women had fewer gains in verbal memory than women experiencing premenopause or postmenopause.

The study also found that beginning hormone therapy with estrogen or progesterone prior to the last period appeared to help cognitive function while fewer improvements were seen in women who started hormone therapy after the last period.  Karlamangla noted, “There is some suggestion that early use of hormone therapy might be helpful, but it's just a hint.”  This doesn’t change the recommendation for using hormone therapy for as short a time as possible at the lowest dose possible for relief of the troublesome symptoms of menopause. The researchers are continuing studies regarding the possible impact of menopausal symptoms such as hot flashes on memory and learning during the menopausal transition period.