The Menopause Case for Mahjong: Connection, Play & Stress Relief

Lifestyle |
4 min read

Written By

Brittany Dick

Published

November 06, 2026

Medically reviewed by

Alyssa Dweck MS, MD, FACOG, MSCP, Chief Medical Officer

In a world of endless demands, many of us crave the reprieve of social connection and fun just for the sake of it. While this matters at any age, stress management during menopause often matters even more.

A weekly game night could offer what you’re looking for.

Enter mahjong.

With roots dating back to 1800s China, mahjong is gaining global popularity and offering women opportunities for connection, amusement, and stress relief.^1,2 The game combines social interaction with memory, pattern recognition, decision-making, and strategy, making it an engaging way to exercise the brain while connecting with others.

Mahjong as a Menopause Ritual

A weekly game night may offer more than just a fun evening. Research suggests that strategic games, like mahjong, can offer several potential benefits:³

1. Connection: Traditionally, mahjong requires four players—although there are variations for playing with fewer people. Playing in a group provides an opportunity for connection with friends and loved ones.

2. Screen-free stress relief: The game requires strategic thinking, which can offer a distraction from everyday life without relying on technology.

3. Cognitive benefits: Researchers suggest that playing mahjong could benefit short-term memory and cognitive abilities. The game’s requirement to remember tiles, recognize patterns, and act strategically may foster brain health.

Mahjong Offers Social Connection, a Must for Menopause Wellness

Research suggests that loneliness may provoke more than just feelings of melancholy. Social isolation has been linked to cognitive decline, a higher risk of chronic disease, and potentially more severe menopause symptoms.^4,5,6

Together, these findings suggest that women who prioritize social connection during menopause may have an easier time coping with menopause symptoms. The game also provides a space for discussion, laughter, and fun, which can support overall well-being during menopause.

Mahjong fosters connection in a unique way.

Traditionally, players sit around a table, sharing conversation while watching tiles, making decisions, and responding to one another’s moves. The game offers an opportunity for a shared activity while still leaving room for connection and laughter.

Mahjong for Stress Management in Menopause

Women in early perimenopause frequently report high stress levels, with around four in 10 experiencing mood symptoms similar to premenstrual syndrome (PMS).^7,8 This should come as little surprise, when you consider that women in midlife may be navigating menopause symptoms on top of caregiving responsibilities, career shifts, and health changes.

Researchers suggest that board games may help decrease stress and depressive symptoms.⁹ Whether you play with friends or family members, games like mahjong can foster social bonding and boost mood by releasing endorphins, “feel-good” hormones that ease stress and anxiety.¹⁰

Mahjong requires players to remain engaged with the tiles, track what’s been played, and consider their next move. This requirement for focus and critical thinking can offer a welcome reprieve from everyday worries.

Mahjong as an Exercise for Brain Health in Menopause

Many women may notice that names, dates, or details of a recent conversation become harder to recall during the menopause transition.

Research suggests there's a biological reason why.

Estrogen may help protect the brain by preserving the neurons responsible for memory processing and speed.¹¹^˒¹² Declines in estrogen during perimenopause may impair these processes, leading to challenges with attention, executive function, and even motor skills.¹³

Women at every stage of menopause, from perimenopause to postmenopause, may experience cognitive changes like brain fog and memory concerns – which are typically transient.¹⁴ Research using brain scans suggests that the menopause transition may be linked to more white matter hyperintensities, small changes on MRI scans that are often associated with reduced blood flow.¹⁵ These changes appear to be more common in women who experience menopause at earlier ages.¹⁶

While the research is still limited, emerging studies suggests that "intellectual sports," such as mahjong, may support cognitive performance.¹⁷^˒¹⁸ During a game, players must remember which tiles have been played, recognize patterns, and adapt their strategy as the game evolves. This may be one reason why researchers suggest that playing mahjong could benefit short-term memory and cognitive abilities.¹⁹ Games like mahjong offer an opportunity to exercise executive functioning, memory, logical reasoning, and problem-solving in a fun, engaging way.²⁰

Menopause Wellness Is Possible

Managing stress, staying socially connected, and keeping your mind engaged can all play a role in how you feel during the menopause transition. A weekly mahjong game is one enjoyable way to support all three at once, with no screens and plenty of conversation. Whether you join a local group or invite a few friends to learn together, making time for play can be a meaningful part of caring for yourself.

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