Menopause:
Memory
Feeling mentally “foggy,” having trouble concentrating, struggling to find the right word or remembering that appointment.
"Brain Fog"
Around 60% of women in menopause or perimenopause report feeling forgetful or having a general “brain fog” that makes it hard to concentrate.
You may find it hard to absorb and recall information or concentrate on simple tasks, forgetting what you walked into a room to do or struggling to remember your neighbor’s name.
Hormonal brain fog is frustrating and annoying. Poor memory, forgetfulness, and difficulty concentrating can negatively impact on a woman’s self-confidence and can have a negative effect downstream on family and career.
Women going through menopause may generally feel a more negative mood, and that mood may be related to memory issues. Not only that, but “brain fog” may also be connected with sleep issues and vascular symptoms associated with menopause, like hot flashes.
Is it brain fog or dementia?
While brain fog is irritating, it’s generally just that – irritating.
…can’t remember where they left their keys
…a friend’s name suddenly pops out of their brains.
…they can’t retrieve the right word in conversation.
MEMORY “BLIPS” – A woman may fear that she is developing early-onset dementia.
Dementia is far more likely to disrupt life and normal activities.
- Have you stopped doing tasks you normally did (household finances, for example) because you feel your unable to do them?
- Have your forgotten how to perform activities such as driving home from the store?
- Women are generally much older than women experiencing menopause.
- They are not often aware enough of their condition to recognize it and tell their doctor.
How long does menopause brain fog last?
Fortunately, menopause brain fog isn’t forever, but the fact is it usually starts in perimenopause and can hang on even into early menopause, meaning women may not feel as sharp or focused for several years.
Decreases in cognitive function (attention/working memory, verbal learning, verbal memory, and fine motor skill) are more evident in the first year after the final menstrual period.
As our bodies adjust to decreased levels of hormones, so do our brains. The brain adapts to a new hormonal environment to maintain functioning; evidence suggests that learning ability and memory returns during later stage menopause.
How to manage menopausal brain fog
Consume water!
Since 75% of the human brain is comprised of water, even negligible levels of dehydration may compromise cognitive functions, which can lead to memory-related issues and poor concentration
Make a conscious effort to drink more water every day. Have two glasses of water as soon as you wake up in the morning or set an alarm every hour to get up from your desk and drink a glass of water.
Eat a well-balanced diet
The Mediterranean Diet has been widely touted for its brain-protective properties, thanks to its inclusion of omega-3s and unsaturated fats. Empirical data reports that eating a mainly Mediterranean diet is linked to a slower rate of cognitive decline and a lower risk of cognitive impairment.
Get plenty of Omegas 3 &6:
Fluid intelligence – our problem-solving smarts – and memory preservation are supported when we have balanced, abundant reserves of Omega fatty acids from our diet. Fish, fish oil, seeds, and nuts all appear to play a role in protecting brain function.
Vitamin B12:
Deficiencies might also cause fuzzy thinking, so be sure you’re getting plenty of this nutrient.
Calorie restriction and intermittent fasting:
Speaking of diet… Calorie restriction (cutting calories by 30%) and intermittent fasting during menopause have been shown to have some protective effects, though both should be done carefully and under the watchful eye of a medical professional.
Finally, avoid large meals, caffeine, nicotine, or alcohol before bed, as they can have a disruptive effect on how easily you’re able to get to sleep and the quality of your sleep.
Exercise
Getting regular physical activity is recommended for all people, including women going through menopause. Researchers believe that moderate-intensity exercise may increase cognitive flexibility and working memory, while high-intensity activity may improve the speed of information processing.
- Aerobic Activity Try getting 30 minutes of cardiovascular exercise at least five days a week for a total of 150 minutes. Activities to try including walking, jogging, cycling, and water aerobics.
- Strength Training Try lifting free weights or using weight machines at your gym at least twice a week. You should aim to do eight exercises with 8 to 12 repetitions.
Exercise your mind
Your brain needs regular workouts as you age.
- Play brain-training games While the jury is definitely still out on how much you can gain from these games, games designed specifically for improved cognition do appear to “confer some benefit”. The games should be fun, challenging, and allow you to graduate to harder challenges as you improve. While brain games may not make us smarter or delay onset of dementia, they may make learning new things easier, even as we age.
- Socialize Research increasingly shows that strong social ties are crucial to your brain health. Socializing can stimulate attention and memory, and help to strengthen neural networks. You may just be laughing and talking, but your brain is hard at work. This increase in mental activity pays off over time.
Rest
Quality Sleep Getting enough quality sleep is also vitally important for overall cognitive function. During the latter stages of your sleep cycle — in rapid eye movement (REM) sleep — your brain stores memories, consolidates ideas, and processes information from the day. Sixty-one percent of postmenopausal women report insomnia issues.
Meditation Stress and anxiety can perpetuate sleep issues, so it’s important to give yourself time to unwind before you go to bed. You may consider meditation, deep breathing, yoga, or having a hot bath, for example. Mindfulness meditation, positivity, reduced stress all reduce internal inflammation which can deteriorate neural pathways.
Can hormone replacement treatment help?
One major change to the body that may cause normal forgetfulness during menopause is a reduction in the body’s hormone levels- Estrogen, Progesterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) play a role in cognition, the ability to understand.
Declining estrogen levels can lead to many discomforts, common symptoms like hot flashes, night sweats, anxiety, and mood swings. These menopause symptoms can keep you up at night and leave you feeling fatigued and mentally drained.
However, these symptoms don’t appear to be the primary cause of brain fog.
Estrogen is a “master-regulator” of our brains.
Estrogen receptors are widely distributed in our brains, and when estrogen levels decline, a critical energy source is gone.
Your brain functioning gets tired.
Evidence suggests that hormonal changes — in particular, those associated with estrogen — are more likely to cause cognitive challenges in menopausal women.
Researchers believe that estrogen may play a role in attention, mood, language, and memory.
Estrogen has been shown to have various effects on the brain, including supporting neurotransmitter function, increasing cerebral blood flow, and promoting neural plasticity (the brain’s ability to change and adapt).
In one study, researchers linked the severity and frequency of hot flashes to lapses in verbal memory.
The Women’s Health Initiative (WHI) study suggested that long-term use of estrogen-progestin combination therapy may be associated with a higher risk of developing dementia compared to those on placebo.
The “progesterone-like” hormone was not a true progesterone and retained unwanted side effects possibly including the increased the risk of dementia. The risk might be lower if woman take micronized progesterone intermittently and start HT early. (On going studies suggest safety with this type of progesterone, we’ll know more soon as rigorous studies wrap up.)
- The effects of hormone therapy on cognitive function can vary among individuals, and more research is needed to better understand why some women may experience different cognitive outcomes than others.
- It’s important to note that hormone therapy is not recommended for the prevention of dementia, and its risks and benefits should be carefully considered on an individual basis.
- The potential risks and benefits of hormone therapy, including its effects on cognition, should be weighed against other factors, such as menopausal symptom management and the risk of other health conditions (e.g., cardiovascular disease, osteoporosis).
- Initiating hormone therapy closer to menopause onset (early menopause) might have different effects on cognitive function compared to starting therapy many years after menopause.
Hormone Replacement Therapy (HRT)
Despite what you’ve likely heard, many, if not most, women can take HRT safely, provided it’s prescribed correctly and you follow your OB/GYN’s recommendations.
Hormone therapy has been shown to sharpen a menopausal mind and may help protect you from further memory loss. According to the National Institute of Health, hormone therapy after menopause can also provide health benefits related to memory.
If you are struggling with memory and brain fog, HRT may be the right solution for you.
For more information on treatment options call the office of County Obstetrics & Gynecology to schedule a consultation.