HealthThe hormonal upheaval in the run-up to menopause can cause cognitive difficulties. But researchers are also finding that this can be a critical window for protecting long-term brain health 20 March 2025 The first sign something was amiss was the tiredness. Then I started forgetting where I had left my phone or keys, only to find them in the fridge or kitchen cupboard. The breaking point came when I went to make a cup of tea before an important interview, only to return 45 minutes later to a string of increasingly irritated emails asking why I wasnt on the call. I had been potting houseplants instead.As a woman in my early 40s, I was aware of this thing called perimenopause looming. But were my symptoms related to this, or justa product of getting older, or simply down to the mental load of juggling work, family and social demands?Teasing out what is perimenopause and what is just life is difficult, but the run-up to menopause can bring some alarming symptoms not least cognitive ones, such as difficulty recalling names, trouble concentrating and putting keys in the fridge.We now know that up to 62 per cent of all perimenopausal and postmenopausal women report these [cognitive symptoms], which can be so severe as to spark fears around early-onset dementia, says Lisa Mosconi, director of the Womens Brain Initiativeat Weill Cornell Medicine in New York.Though long ignored or dismissed as inevitable consequences of ageing, the neurological manifestations of menopause are finally drawing scientific interest. It is increasingly clear brain changes occur during this period and that some can ultimately be positive. More than that, these changes demonstrate that menopause may offer a crucial window for