Published online Aug 19, 2021. doi: 10.5498/wjp.v11.i8.412
Peer-review started: February 15, 2021
First decision: June 24, 2021
Revised: July 5, 2021
Accepted: July 28, 2021
Article in press: July 28, 2021
Published online: August 19, 2021
Processing time: 177 Days and 8.9 Hours
A severe impairment of cognitive function characterizes dementia. Mild cognitive impairment represents a transition between normal cognition and dementia. The frequency of cognitive changes is higher in women than in men. Based on this fact, hormonal factors likely contribute to cognitive decline. In this sense, cognitive complaints are more common near menopause, a phase marked by a decrease in hormone levels, especially estrogen. Additionally, a tendency toward worsened cognitive performance has been reported in women during menopause. Vasomotor symptoms (hot flashes, sweating, and dizziness), vaginal dryness, irritability and forgetfulness are common and associated with a progressive decrease in ovarian function and a subsequent reduction in the serum estrogen concentration. Hormone therapy (HT), based on estrogen with or without progestogen, is the treatment of choice to relieve menopausal symptoms. The studies conducted to date have reported conflicting results regarding the effects of HT on cognition. This article reviews the main aspects of menopause and cognition, including the neuroprotective role of estrogen and the relationship between menopausal symptoms and cognitive function. We present and discuss the findings of the central observational and interventional studies on HT and cognition.
Core Tip: Cognitive complaints are more common in postmenopausal women than in premenopausal women. Due to the reduction in ovarian function, a progressive decrease in serum estrogen levels occurs, leading to menopausal symptoms with an emphasis on vasomotor symptoms. In addition to these symptoms, cognitive impairment can affect postmenopausal women to varying degrees. Several aspects of the relationship between menopause and cognitive function were reviewed. We report the latest evidence on the topic. In this sense, considering current knowledge, we do not recommend the prescription of hormone therapy to prevent cognitive decline or dementia in postmenopausal women.