Comparison of Health, Quality of Life, and Psychological and Cognitive Function Between Perimenopausal and Postmenopausal Women: A Cross-Sectional Study

Background: Menopause is associated with hormonal changes that may influence cognitive function, psychological health, and quality of life, but data on Middle Eastern populations remain scarce. Methods: A cross-sectional study was conducted among 220 Saudi women (110 perimenopausal, 110 postmenopausal) in Riyadh. Cognitive function was assessed with the MMSE-2; quality of life with SF-36 and MENQOL; and psychological distress with PHQ-4 and PSS-10. Group comparisons used the Mann–Whitney U test; associations with Spearman’s correlation; and multivariable logistic regression adjusted for age, BMI, education, and anxiety. Results: In unadjusted analyses, perimenopausal women had higher MMSE-2 scores (median 30 vs. 29, p = 0.002, r = 0.211). Postmenopausal women reported greater vasomotor symptoms (p < 0.001, r = 0.090) but better emotional well-being (p = 0.038, r = 0.140). After adjustment for age, menopausal status was not a significant predictor of lower cognitive function (OR = 1.28, 95% CI: 0.56–2.92, p = 0.560). Age was the only significant predictor (OR = 1.10, 95% CI: 1.03–1.17, p = 0.003). Conclusions: The unadjusted difference in MMSE-2 scores between perimenopausal and postmenopausal women was small and not independent of age. Age, not menopausal status, was the primary factor associated with cognitive performance. Preventive strategies should target modifiable factors such as physical activity and vasomotor symptom management. Longitudinal studies with domain-specific cognitive tests are needed.