Perspective from Stephanie Faubion, MD, MBA

Press Release

Disclosures: The authors report no relevant financial disclosures.

January 13, 2022
2 min read

Severity of menopausal symptoms impacts cognitive performance

Perspective from Stephanie Faubion, MD, MBA

Press Release

Disclosures: The authors report no relevant financial disclosures.

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

We were unable to process your request. Please try again later. If you continue to have this issue please contact

The cognitive performance of women was sensitive to the severity of their menopausal symptoms, particularly depression and sexual dysfunction, according to a cross-sectional study published in Menopause.

The study included 404 women aged 40 to 65 years (mean age, 50.78 years) living in the rural areas of district Rupnagar, Punjab, India, according to Mankamal Kaur, MSc, a research scholar, and Maninder Kaur, PhD, chair and assistant professor, both of the department of anthropology at Panjab University in Chandigarh, India.

The most common menopausal symptoms among late postmenopausal women include depression (67%), sexual dysfunction (67.8%) and somatic symptoms (63.5%).
Kaur M, et al. Menopause. 2021;doi:10.1097/GME.0000000000001910.

With a mean age at menarche of 14.89 ± 0.08 years and at menopause of 47.24 ± 0.32 years, 107 of the participants were premenopausal, 90 were perimenopausal, 92 were early menopausal and 115 were late menopausal according to WHO criteria.

Also, 83.4% were married, and 93.8% did not have any kind of private or government job. In terms of education, 22.5% were illiterate, 37.6% had primary to middle school education, 32.2% had a high school degree and 7.7% were graduates or postgraduates.

The women were evaluated according to the Greene Climacteric Scale, which evaluates 21 menopausal symptoms across psychological, somatic, vasomotor and sexual interest classifications.

Depression (67%), somatic (63.5%) and sexual dysfunction (67.8%) were highest among late postmenopausal women. Anxiety (58.7%) and vasomotor symptoms (59.8%) were highest among early postmenopausal women.

Also, the women completed a 30-point Hindi version of the Mini-Mental State Examination (MMSE) to gauge their global cognitive performance across its orientation to time and place, registration, attention and calculation, recall, and language and visuo-spatial ability subdomains.

Women with severe menopausal symptoms had significantly lower mean values for orientation (8.11 vs. 8.9; P < .001), registration (2.77 vs. 2.91; P < .001), attention (4.31 vs. 4.48; P < .01), recall (2.26 vs. 2.53, P < .05) and language/visio-spatial skills (7.13 vs. 7.91, P < .001) than women with mild symptoms.

In a univariate linear regression analysis, the severity of each menopausal symptom was negatively and significantly associated with global cognitive scores, the researchers said.

In the multivariate linear regression analysis, though, only severe depression and greater intensity of sexual dysfunction had a negative and significant association with MMSE scores.

After adjusting for age and marital and educational status, the researchers found that severe depression and sexual dysfunction were the only symptoms with a significant association with overall cognitive performance.

Severe vasomotor symptoms were not predictors of cognitive performance in all the cognitive domains on the MMSE scale except for attention, and once the researchers adjusted for covariates in the model, its significance was lost as well. No significant association was observed between somatic symptoms and cognitive performance either.

Although more longitudinal and cross-sectional studies of large population-based samples could clarify these associations, the researchers said, they believe their results can help rural services address these issues and help many women.