Menopause transition stage and endogenous estradiol and follicle-stimulating hormone levels are not related to cognitive performance: Cross-sectional results from the study of women's health across the nation (SWAN)

Background: By one estimate, 60% of women experiencing the menopause transition perceive that they have memory problems, but most studies that have used cognitive function tests have not substantiated a relation between menopause stage and cognitive performance. We sought to describe the cross-sectional relation between menopause status, estradiol (E-2), follicle-stimulating hormone (FSH), and measured cognitive function. Methods: Cross sectional analysis of a community-based cohort of midlife women was used. Cognitive tests were the East Boston Memory Test, Symbol Digit Modalities, and Digits Span Backward. Menopause categories ( premenopausal, early perimenopausal, late perimenopausal, and postmenopausal) were defined based on menstrual patterns. One set of general linear models assessed the relations between each cognitive test and menopause transition category, initially adjusted for age, race/ethnicity, education, symptoms, self-rated general health, and body mass index (BMI); next, these were additionally adjusted for FSH and E-2. A second set of models, stratified by menopause status, examined the possible relations between each cognitive test and either E-2 or FSH, adjusted for age, race/ethnicity, education, symptoms, self-related general health, and BMI. Results: The mean age of the analytical sample (n = 1657) was 49.7 years. Only 5% of the sample had less than a high school education, 16% graduated from high school, and the rest had at least some college. The percent of women in each menopause category was premenopausal (9.0%), early perimenopausal (57.0%), late perimenopausal (13.4%), postmenopausal (20.6%). Although clinical-site adjusted models showed moderate differences between menopause transition groups and cognitive performance, no association was found between each of the measured cognitive performance tests and menopause transition status when adjusting for covariates. Similarly, no association between each cognitive test and E-2 or FSH was found. Conclusions: This study does not support a cross-sectional relation between cognitive test performance and menopause stage, FSH, or E-2.