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Cognitive functioning in perimenopause: An updated systematic review and meta-analysis.
Amanda Bangle1, Danielle Williams1, Jared Walters2
1School of Applied Psychology, Griffith University.
Psychology and Aging
|October 9, 2025
Summary
During perimenopause, women experience cognitive changes compared to premenopausal women, especially when using standardized staging. Cognitive function differences between perimenopausal and postmenopausal women depend on research methods used.
Area of Science:
- Reproductive Aging and Cognitive Health
Background:
- Perimenopause involves hormonal fluctuations impacting cognition, leading to frequent subjective complaints like forgetfulness.
- Existing research on cognitive changes during perimenopause shows inconsistencies due to varied methodologies and comparison groups.
- Objective cognitive deficits are reported, but findings differ regarding attention, memory, and executive function.
Purpose of the Study:
- To systematically review and meta-analyze cognitive differences in perimenopausal women compared to both premenopausal and postmenopausal women.
- To clarify inconsistent findings by examining the impact of methodological variability, including reproductive staging criteria.
- To provide a clearer understanding of cognitive changes during the menopausal transition for improved clinical assessment and interventions.
Main Methods:
- Systematic review and meta-analysis of 26 studies involving 9,428 participants.
- Comparison of cognitive outcomes between perimenopausal and premenopausal women (21 studies).
- Comparison of cognitive outcomes between perimenopausal and postmenopausal women (21 studies), analyzing moderators like STAGES OF REPRODUCTIVE AGING WORKSHOP (STRAW+10) criteria.
Main Results:
- Perimenopausal women showed poorer cognitive outcomes than premenopausal women (moderate effect), particularly in studies using STRAW+10 criteria.
- No significant cognitive differences were found between perimenopausal and postmenopausal women overall.
- Studies not using STRAW+10 criteria indicated better cognition in perimenopausal than postmenopausal groups; perimenopausal women had better objective cognitive function but trended towards poorer self-reported outcomes compared to postmenopausal women.
Conclusions:
- Standardized reproductive staging (STRAW+10) is crucial for accurately assessing cognitive changes during perimenopause.
- Incorporating both subjective and objective cognitive assessments is vital for comprehensive research.
- Understanding perimenopausal cognitive changes can enhance clinical support and interventions for midlife women's cognitive health.
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