About 75 percent of people experience memory problems as they get older. Causes include dementia and Alzheimer's disease (AD). Women are more likely to be affected by AD and dementia than men.

As women reach menopause, they also struggle with forgetfulness and "brain fog," and for some, this memory depletion continues after menopause. Some researchers have found that women have difficulty with verbal fluency at these times, too.

Nevertheless, women with healthy aging brains continue to have an edge over their male counterparts when it comes to memory function, even in midlife and older age.

Indeed, some studies suggest that, even from childhood, women outperform men in memory tasks. This is especially true of verbal memory. The difference becomes more significant just after puberty, and it continues into adulthood.

Research has suggested that verbal and associative aspects of memory are more likely to be impaired than nonverbal function as people get older.

It also seems that people who experience problems with verbal memory before the age of 50 years are more likely to face additional cognitive impairments after the age of 65 years.
How do hormones affect memory?

Researchers from Boston, MA, have been investigating how the menopause and levels of sex steroids might affect particular aspects of memory.

Neuroactive sex steroid hormones, including estradiol, are believed to affect learning and memory in women, and they may underlie sex differences in learning and memory performance.

Estradiol affects the structure and function of brain regions that relate to memory. As levels fluctuate during the menstrual cycle, verbal working memory performance can change, too.

To find out more, the team decided to investigate memory function as it relates to estradiol levels in early midlife.

They hypothesized that sex differences, hormones, and reproductive status might correlate with changes in memory performance.

The researchers also wanted to know which memory domains are most likely to be impaired in menopausal women and whether the level of memory function in early midlife might predict the future onset of AD, based on family history.
Despite a dip at menopause, women outperform men in memory tests

The participants were 212 men and women aged between 45-55 years.

Challenging memory tests were used to assess episodic memory, executive function, and semantic processing. Cognitive testing was used to measure verbal intelligence.

The team compared performance between men and women, and also between women at different stages, before, during, and after menopause.

Results showed that women outperformed men, and that women who were premenopausal or perimenopausal scored better than women who were postmenopausal. Performance was linked to estradiol levels, regardless of chronological age.

As estradiol declines during menopause, women find it harder to learn something for the first time and to retrieve information. However, they continue to maintain and consolidate stored memories effectively. The findings suggest that different parts of the brain are affected.

Previous studies have shown that women with a longer reproductive period, and therefore greater exposure to estrogens, have better immediate and delayed verbal memory in mid- to late-life.

A fall in estradiol levels during menopause has also been found to relate directly to changes in brain activity in the hippocampus, which plays a role in memory function.
Is there a link with Alzheimer's?

The parts that are affected appear to be different from those affected by early AD, and the team found no indication of a link between menopausal brain deficits and AD.

"Brain fog" and forgetfulness have sometimes been attributed to job stress and the need to multitask, rather than menopausal transition.

The current study confirms other findings suggesting that menopause, and more specifically, estradiol, may play a role.

The researchers conclude that the cognitive changes that occur during menopause are probably related to hormonal processes affecting frontal executive neural networks, rather than temporolimbic dysfunction, which is implicated in AD.

One limitation of the study is that it is cross-sectional rather than longitudinal. A study over time would give a fuller picture.

Other potential causes of memory problems, say the authors, could be estrogen from sources other than estradiol, a result of psychosocial pressures, or symptoms of some other passing condition.

The authors conclude that women's memories are better than men's in early midlife, and when women's memories start to decline, this is due to reproductive status rather than age. The loss of ovarian estradiol plays a role.

They hope that additional research will lead to a better understanding of which changes in memory relate to healthy aging, and which ones are early signs of AD and future memory loss.

Invited to comment on the study, Prof. JoAnn Pinkerton, executive director of the North American Menopause Society (NAMS) and professor of obstetrics and gynecology at the University of Virginia Health Center in Charlottesville, suggested to Medical News Today that there may one day be therapeutic benefits.

She told MNT:

    "Women with early menopause or persistent vasomotor symptoms, particularly those starting hormone therapy before age 60 or within 10 years of menopause, may be most likely to benefit from hormone therapy, including any potential benefits on memory or cognition."
Prof. JoAnn Pinkerton
   
Fast facts about memory loss

    In 12.6 percent of American households, one or more people have confusion or memory loss
    In 6 percent of households, all adults have confusion or memory loss
    Causes include vitamin B12 deficiency, alcoholism, tumor, infection or blood clots in the brain.