Main Points: - This cross-sectional MRI study looked at cerebral blood flow (CBF) in premenopausal, perimenopausal, and postmenopausal women compared to similar-aged men. - Premenopausal women had higher CBF in whole brain, gray matter, and white matter compared to the other groups. - Perimenopausal and postmenopausal women had more white matter hyperintensities (WMHs) than premenopausal women and men. - Multivariate regression analysis showed menopause status and the interaction of age and menopause status significantly affected CBF. - Premenopausal women showed slight CBF increases with age, while peri- and postmenopausal women showed CBF declines. Clinical Implications: - The findings suggest alterations in brain perfusio ...