Aging is the strongest risk factor for cognitive decline. The perimenopausal period puts women in a more vulnerable state in regard to certain functions such as memory. Also, the Women's Health Initiative Memory Study (WHIMS) pointed at some cognitive adverse effects of postmenopausal hormone therapy, but these results were not relevant for the peri- and early menopause since WHIMS recruited women above the age of 65 years. The 'window of opportunity' theory, pointing at potential protective effects of postmenopausal hormone therapy in the early menopause, mainly applies to coronary artery disease, but clinical data on neuroprotection by estrogen are not consistent. In view of a recent publication, the following article discusses the issue of menopause and cognitive decline, with a focus on possible associations with surgical menopause.