Menopause is an inevitable natural event in a womans life and results from hypo-ovarianism. Symptoms such as osteoporosis, cardiovascular dysfunction, and urogenital tract atrophy are common in postmenopausal women. Menopausal hormone therapy (MHT) can remarkably improve the symptoms of menopause. Recent studies have shown that MHT is associated with cognitive function, while there are significant differences in approaches and results. This article explores several factors that significantly influence cognitive function, including therapeutic time window, type of menopause, baseline condition, and therapeutic regimen, so as to provide reference for the therapy opportunity choice of clinical MHT.