Key Points

• Women commonly report memory or cognition changes associated with the menopause transition and menopause. Women may refer to this as ‘brain fade’ or ‘brain fog’.
• However, the contributing roles of menopause related to oestrogen decline, aging, effect of co-morbidities, psycho-social functioning and menopauserelated symptoms such as insomnia and hot flushes need clarification.
• Cognitive changes associated with the menopause transition include reduced processing speed and reduced verbal memory. Verbal memory is defined as the ability to encode words and it is influenced by circulating oestradiol.
• MHT has positive or neutral effects of cognitive function in younger peri- or postmenopausal women. The age of the woman, MHT preparation and baseline cognitive function influence this effect.
• Cognitive testing is not indicated unless the symptoms are progressive and interfere with work performance or relationships.