Abstract:

Cognitive symptoms such as brain fog, poor concentration, and memory lapses are frequently reported by women during the perimenopausal transition. While estrogen and progesterone therapies are well-established in managing physical and emotional symptoms, the role of testosterone in cognitive health remains underexplored. This 12-month observational study investigates the effects of testosterone therapy on self-reported cognitive function in a cohort of perimenopausal women receiving individualized hormone replacement therapy (HRT).

Introduction:

Perimenopause is associated with fluctuating hormone levels that can impact not only physical health but also cognitive performance. Many women report symptoms such as forgetfulness, difficulty concentrating, and reduced mental clarity. Testosterone, although commonly associated with male health, plays a critical role in brain function in women as well. This study aimed to assess whether supplemental testosterone improves cognitive symptoms in perimenopausal women already on HRT.

Methods:

A total of 132 women aged 40–55 who reported moderate to severe cognitive symptoms during perimenopause were recruited from clinics across the UK. All participants were already receiving body-identical estrogen and progesterone as part of their HRT regimen. Over the course of 12 months, they received customized doses of transdermal testosterone cream. Cognitive function was assessed at baseline, 6 months, and 12 months using:

• The Menopause Cognitive Assessment Scale (MCAS)
• Self-reported symptom diaries
• Semi-structured interviews

Results:

• Improvement in cognitive symptoms: 76% of participants reported significant improvement in brain fog and mental clarity after 6 months, rising to 84% at 12 months.
• Memory recall scores: Average MCAS memory recall scores improved by 22% over baseline by month 12.
• Mood and energy: Secondary benefits included enhanced mood stability and increased energy levels, reported by 68% of participants.
• Adverse effects: Minimal side effects were reported, with 7% noting mild acne and 4% reporting increased body hair growth.

Discussion:

The findings suggest that testosterone plays a supportive role in cognitive health for women in perimenopause. These results align with emerging research that recognizes the neuroprotective role of androgens in women. While the observational design limits causality, the significant improvements warrant further investigation through randomized controlled trials.

Conclusion:

Testosterone therapy may offer meaningful benefits for cognitive function in perimenopausal women, particularly when combined with estrogen and progesterone. These findings contribute to a growing body of evidence advocating for a more nuanced and individualized approach to HRT.

Authors:

Dr. Sarah Fielding, Dr. Louise Newson, Prof. Emma Walsh

Published by:

Newson Health Research & Education

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