Type of Hormone Therapy Used After Menopause Affects Memory Performance

FRIDAY, Aug. 29, 2025 (HealthDay News) — Earlier age at menopause is associated with lower scores on all cognitive domains, and menopausal hormone therapy (MHT) differentially affects cognition, according to a study published online Aug. 27 in Neurology.

Tanvi A. Puri, from the University of British Columbia in Vancouver, Canada, and colleagues conducted a cross-sectional observational cohort study using baseline data from the Canadian Longitudinal Study of Aging. The associations of age at menopause and estradiol (E2)-based MHT by administration route were examined with performance in three cognitive domains in a cohort of 7,251 postmenopausal women.

The researchers found that across all cognitive domains tested, earlier age at menopause was significantly associated with lower scores (β = 0.050, 0.047, 0.061, respectively, for episodic memory, prospective memory, and executive functions). For executive functions, only those with four or more children versus no children had lower performance in association with earlier age at menopause (β = 0.215); a greater effect size was seen among APOE4 ε4 carriers versus noncarriers (β = 0.070). Transdermal E2 was associated with higher episodic memory scores, and oral E2 was associated with higher prospective memory scores compared with never taking MHT. Executive functions were not affected by either administration route.

“This study highlights that the type of estradiol therapy used may influence cognitive performance differently across various types of memory,” coauthor Liisa A.M. Galea, Ph.D., also from the University of British Columbia, said in a statement. “Understanding these links could help inform more tailored approaches to maintaining brain health after menopause.”

Abstract/Full Text

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