CLEVELAND, Ohio (April 15, 2026)—Cognitive decline not only affects a woman’s quality of life but also her ability to lead an independent lifestyle later in life. A new large-scale study suggests that a longer reproductive lifespan, resulting in greater exposure to endogenous estrogen, is associated with better cognitive health. Results of the study are published online today in Menopause , the journal of The Menopause Society.
Cognitive decline can be considered a preclinical marker of dementia. Women experience faster cognitive decline than men, and it is hypothesized that sex hormones may contribute to this disparity. Reproductive span, defined as the time between age at menarche and age at menopause, represents an important aspect of natural estrogen exposure, although previous studies found inconsistent results between reproductive span and cognition. Studies on the effects of hormone therapy on cognition have also yielded conflicting results.
Given these inconsistencies in prior research regarding reproductive span and timing of hormone therapy initiation on cognitive decline, this new study used more than 30 years of prospectively collected data from more than 14,000 women to evaluate reproductive span, age at menarche, age at menopause, and surgical menopause and their associations with cognition. The results confirmed that a longer reproductive span is associated with better cognitive maintenance. However, hormone therapy use within 10 years of menopause showed no cognitive benefits.
Survey results are published in the article “ Prospective study of reproductive span and menopausal hormone therapy and cognitive decline over 8 years in the Nurses’ Health Study .”
“This large observational study showed an association of longer reproductive span with better cognitive trajectories. However, longer duration of hormone therapy use, either within or outside 10 years of menopause, was not associated with better global cognitive performance. Although the results of this well-designed study may still be affected by residual confounding, they support current guidelines that recommend against the use of hormone therapy for prevention of dementia,” says Dr. Stephanie Faubion, medical director for The Menopause Society.
For more information about menopause and healthy aging, visit www.menopause.org.
The Menopause Society is dedicated to empowering healthcare professionals and providing them with the tools and resources to improve the health of women during the menopause transition and beyond. As the leading authority on menopause since 1989, the nonprofit, multidisciplinary organization serves as the independent, evidence-based resource for healthcare professionals, researchers, the media, and the public and leads the conversation about improving women’s health and healthcare experiences. To learn more, visit menopause.org.
Menopause
10.1097/GME.0000000000000002782
Survey
People
Prospective study of reproductive span and menopausal hormone therapy and cognitive decline over 8 years in the Nurses' Health Study
15-Apr-2026
None reported.