Longer Reproductive Lifespan Linked to Better Cognitive Function, suggests study

A new study published in the journal of Menopause revealed that older women with a reproductive lifespan of 41–46 years demonstrated better performance on cognitive tests compared with those whose reproductive lifespan was 33 years or less. However, menopausal hormone therapy use was not associated with improved cognitive scores. The findings suggest that longer lifetime exposure to endogenous estrogen may support cognitive health in later life.

A large prospective study has found that women with a longer reproductive span—a marker of greater lifetime exposure to endogenous estrogen—may experience better cognitive aging later in life. The findings add to growing evidence that naturally occurring estrogen could play a role in preserving brain health, while also shedding light on the complex relationship between  and cognitive function.

This study analyzed data from 14,217 participants in the long-running Nurses’ Health Study, with an average age of 74.3 years during the start of cognitive assessments. Between 1995 and 2008, the cognitive performance were tracked using four telephone-based interviews. Cognitive change was measured through a global composite score derived from 6 standardized cognitive tests.

The primary focus of this study determined whether a woman’s reproductive span (from the onset of menstruation (menarche) to menopause) was associated with cognitive trajectories in later life. Also, this research examined the impact of menopausal hormone therapy (MHT), paying particular attention to when therapy was initiated after menopause.

Women with reproductive spans of 41 to 46 years demonstrated better cognitive trajectories when compared to those whose reproductive spans were 33 years or less. The findings suggest that prolonged exposure to naturally produced estrogen may contribute to maintaining cognitive function as women age.

When compared to non-users, the women who used MHT during the first 10 years after menopause showed a trend toward faster cognitive decline. Longer durations of MHT use within this early postmenopausal period were associated with increasingly negative cognitive outcomes. However, MHT use initiated or continued 11 or more years after menopause was not significantly associated with cognitive change, which indicated that timing may influence the relationship between hormone therapy and brain health.

Overall, these results do not support the use of MHT to prevent cognitive decline. Instead, it highlights the importance of understanding how hormonal factors across a woman’s lifespan may influence long-term brain health.

Source:

Juramt, N., Kang, J. H., Wang, D. D., Vyas, C. M., Peng, C., Curhan, S., Warner, E. T., Zeleznik, O. A., Rosner, B. A., Wang, M., Stampfer, M. J., Grodstein, F., Okereke, O. I., & Eliassen, A. H. (2026). Prospective study of reproductive span and menopausal hormone therapy and cognitive decline over 8 years in the Nurses’ Health Study. Menopause (New York, N.Y.). https://doi.org/10.1097/GME.0000000000002782