AEROBIC exercise may provide greater cognitive benefits for post-menopausal women than for women who have not yet reached menopause, according to new research.
The randomized controlled trial analysis found that post-menopausal women who completed a 6-month aerobic exercise programme experienced greater improvements in executive function compared with those undertaking stretching and toning exercises, as well as pre-menopausal participants.
The findings suggest menopausal status may influence how the brain responds to exercise.
Researchers analysed data from 93 cognitively healthy women aged between 20 and 67 years with below-average cardiovascular fitness. Participants were randomly assigned to either aerobic exercise or stretching and toning, completed four times per week for 6 months.
The aerobic programme included using a treadmill, elliptical, or stationary bicycle, with intensity gradually increased to 75% of participants’ maximum heart rate. Each session lasted approximately 1 hour.
Participants underwent neuropsychological testing and cardiorespiratory assessments at baseline, 3 months, and 6 months. Menopausal status was also recorded, with approximately 37% of participants classified as post-menopausal.
Overall, 76 participants completed 3 months of exercise and 66 completed the full 6-month intervention.
Researchers found that menopausal status influenced the relationship between exercise and changes in executive function at both 3 and 6 months.
Women who were post-menopausal who undertook aerobic exercise experienced greater improvements in executive function than those completing stretching and toning. The benefits of aerobic exercise were also greater among post-menopausal women than among pre-menopausal women undertaking the same type of exercise.
Executive functions are higher-level cognitive abilities involved in planning, switching between tasks, resisting distractions, inhibiting responses, and adapting thinking to changing situations. These skills play an important role in everyday activities and maintaining independence as people age.
However, the findings did not extend across all areas of cognition. Menopausal status did not significantly influence the effect of exercise on processing speed at either 3 or 6 months.
Exploratory analyses similarly found no significant menopause-related differences in exercise response for episodic memory, working memory, attention, or language.
Because post-menopausal participants were older on average, the researchers also examined whether age could explain the findings. Menopausal status was strongly associated with age; however, the relationship between menopausal status, aerobic exercise, and improved executive function remained significant after researchers accounted for age.
This suggests that menopausal status may influence how executive function responds to aerobic exercise beyond the effects of chronological ageing alone, although the researchers noted that the effects of age and menopause could not be completely separated.
The researchers also investigated whether changes in estradiol hormone could explain the findings. However, neither exercise programme produced significant changes in estradiol, and hormone changes were not associated with cognitive improvements.
The authors noted several limitations. The study was a secondary analysis of an existing randomised trial and was not originally designed to examine menopause-related differences, resulting in a relatively small sample.
Menopausal status was also largely self-reported, and researchers were unable to examine different stages of the menopausal transition, including perimenopause.
Nevertheless, the findings highlight aerobic exercise as a potentially important strategy for supporting cognitive health in women who are post-menopausal.
Further trials are needed to determine how menopause and hormonal changes influence the brain’s response to exercise and whether these benefits could contribute to reducing long-term cognitive decline.
Reference
Sanz Simon S et al. Can menopausal status moderate the effects of aerobic exercise on executive functions? Evidence from a randomized controlled trial. Journal of Alzheimer’s Disease. 2026.
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