No strong evidence testosterone therapy improves menopausal brain fog, study finds

No strong evidence testosterone therapy improves menopausal brain fog, study finds

To examine whether testosterone could improve cognitive performance, researchers assessed five studies that investigated its effects on executive function, verbal learning and memory, and visuospatial learning and memory.

Women dealing with menopause often experience hot flushes, night sweats, mood swings, poor sleep and brain fog, prompting some to explore different ways of managing the symptoms. Among the treatments gaining attention on social media is testosterone therapy to manage forgetfulness, poor concentration and memory difficulties commonly described as ‘brain fog’. However, a new review has found insufficient evidence that the hormone improves memory and thinking abilities during or after menopause.

The findings were published in the peer-reviewed journal Reproduction and Fertility by researchers from University College London (UCL) and announced in a research release published through EurekAlert.

The researchers reviewed five studies involving women aged 41 to 65 to establish whether testosterone therapy improves memory, learning and other thinking abilities in postmenopausal women.

The review comes amid growing interest in testosterone as a possible treatment for menopausal symptoms, with some women using the hormone in the hope of improving concentration, memory and mental clarity.

Menopause is a natural stage in a woman's life when menstrual periods stop because of declining hormone levels. It usually occurs between the ages of 45 and 55. Post-menopause begins after a woman has gone 12 consecutive months without a menstrual period.

During the menopause transition and after menopause, some women report cognitive difficulties commonly referred to as brain fog. These may include struggling to remember words and numbers, misplacing everyday items, difficulty concentrating and forgetfulness.

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Unlike oestrogen, which declines significantly during menopause, testosterone levels gradually decrease from a woman's mid-20s to early 30s rather than experiencing a sudden drop during the menopause transition.

To examine whether testosterone could improve cognitive performance, researchers assessed five studies that investigated its effects on executive function, verbal learning and memory, and visuospatial learning and memory.

Participants received testosterone or a placebo through daily, weekly or monthly treatments over periods ranging from four to 26 weeks. Researchers then compared their cognitive performance to establish whether those receiving testosterone experienced improvements.

A further analysis combining results from three of the five studies involved 244 women participating in randomised controlled trials. The researchers found no statistically significant improvement in cognitive function among women receiving testosterone compared with those given a placebo.

According to the research, claims that testosterone improves memory and brain fog have become increasingly common, particularly on social media, with some women taking the hormone specifically to manage these symptoms during menopause.

The researchers noted that although some women in perimenopause have reported benefits, this group was not included in the studies reviewed, making it difficult to establish whether testosterone could improve their symptoms.

The findings should not be interpreted as proof that testosterone does not affect memory or thinking abilities. Rather, the available studies were too few and involved relatively small numbers of participants to establish whether the treatment provides meaningful benefits.

According to the research, the available evidence is limited and insufficient to determine whether testosterone therapy improves cognitive symptoms during the menopause transition and after menopause.

The researchers emphasised that this reflects a lack of sufficient evidence rather than proof that the hormone has no effect.

“Testosterone is sometimes prescribed to women experiencing low sexual desire, particularly when other menopause treatments have not helped. However, its effectiveness in improving memory and concentration remains uncertain.” According to research

Researchers called for larger studies to establish whether testosterone has any role in brain health and cognitive function among women going through menopause.

They also recommended further research into how women experience changes in memory, concentration and thinking during menopause to understand their symptoms and treatment needs better.

The findings highlight the need for more evidence before testosterone can be recommended as a treatment for menopausal brain fog.

The World Health Organisation recommends integrating menopause care into routine health services, giving women access to information, counselling, diagnosis, and appropriate treatment.

It advocates for a life-course approach that addresses women's physical, mental, emotional and social well-being, alongside training healthcare workers to recognise and manage menopause symptoms.

Treatment should be guided by a woman's symptoms, medical history and preferences. However, WHO has not issued a specific recommendation for using testosterone to treat menopausal brain fog, and evidence that it improves memory and concentration remains insufficient.

The number of women living after menopause is rising globally. A 2022 review published in the BMJ estimated that about 1.02 billion women worldwide were postmenopausal in 2021, with the figure projected to reach 1.65 billion by 2050.