Estrogen and Cognitive Functioning in the Menopause Transition

Most women report cognitive problems in the menopause transition (i.e. ‘perimenopause’), which refers to the five or so years preceding the final menstrual period. Chief concerns allude to forgetfulness, fuzzy thinking, poor working memory, and poor concentration. Although it has been proposed that the hormonal changes associated with the menopause transition may be a contributing factor, very little research has been devoted to studying the effect of reproductive hormones on cognitive functioning during this transition period. The goal of this study was therefore to improve our understanding of the role that reproductive hormone changes play in triggering perimenopausal cognitive difficulties. As such, this is the first study to repeatedly assess the relationship between estradiol levels and subjective and objective cognitive ability within the same perimenopausal woman, allowing for the detection of any transient cognitive weaknesses and their possible relation to temporarily low levels of estradiol. Participants were women (n = 43) aged 45-55 years and who are currently in the menopause transition (defined according to menstrual bleeding patterns). Once a week for 12 weeks, participants provided a urine sample for the measurement of estrone-3- glucuronide (E1G), a urinary metabolite of estradiol, and completed questionnaires assessing subjective cognitive performance. Every three weeks across the 12-week period, participants also underwent cognitive testing, including assessments of immediate and delayed memory, attention, and executive function. Potential confounding variables including sleep quality, vasomotor symptoms, and depressive symptoms were also assessed. It was hypothesized that weeks characterized by low relative E1G would also be characterized by weaknesses in both subjective and objective cognitive ability. Findings suggest that in perimenopause, low levels of endogenous estradiol are associated with worse performance on objective measures of attention, particularly the ability to passively register auditory information on the first pass, subjective measures of memory, specifically relating to a higher frequency of forgetting things in everyday life, and objective attention and short-term memory among perimenopausal women with lower estimated levels of intellectual functioning. Depressive symptoms, vasomotor symptoms and sleep quality did not significantly account for the effects on objective cognitive outcomes. In addition, despite subjective complaints of cognitive dysfunction, all participants performed within the broad average range or higher on objective cognitive measures. As such, while the impact of estradiol on cognitive function was noticeable to some participants, estradiol’s impact on objective cognitive performance was relatively small. Taken together, these findings provide evidence that validates and legitimizes perimenopausal women’s cognitive complaints. Findings also provide reassurance that these weaknesses are normal and, while bothersome, transient. This research points to the potential for investigating interventions such as hormone therapy for women reporting disruptive cognitive weaknesses.

Name thesis:degree_name

Doctor of Philosophy (PhD)

Level thesis:degree_level

Doctoral -- first

Discipline thesis:degree_discipline

Clinical Psychology

Grantor dc:publisher

Faculty of Graduate Studies and Research, University of Regina

Year dc:date.issued

2021

Author dc:creator

• Grummisch, Julia Anne

Advisor dc:contributor.advisor

• Gordon, Jennifer

Committee members dc:contributor.committeemember

• Sykes Tottenham, Laurie
• Hadjistavropoulos, Thomas
• Urban, Ann-Marie

Language dc:language.iso

en

DOI

https://doi.org/10.82465/3709

OAI identifier oai:identifier

oai:uregina.scholaris.ca:10294/14935