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Background: There is almost no longitudinal information about measured cognitive performance during the menopause transition (MT).

Methods: We studied 2,362 participants from the Study of Women's Health Across the Nation for 4 years. Major exposures were time spent in MT stages, hormone use prior to the final menstrual period, and postmenopausal current hormone use. Outcomes were longitudinal performance in three domains: processing speed (Symbol Digit Modalities Test [SDMT]), verbal memory (East Boston Memory Test [EBMT]), and working memory (Digit Span Backward).

Results: Premenopausal, early perimenopausal, and postmenopausal women scored higher with repeated SDMT administration (p ≤ 0.0008), but scores of late perimenopausal women did not improve over time (p = 0.2). EBMT delayed recall scores climbed during premenopause and postmenopause (p ≤ 0.01), but did …