Whats in your Cart?
At the age of 52 I started to experience changes to the way my brain worked, especially in relation to word finding, short term memory and focus. It was very unsettling and at times, alarming.
I didn’t realise that these changes were common during the menopause transition and could be considered normal. I had no idea why they were happening, if they were temporary or permanent and I found it extremely hard to find clear answers to these questions, despite many hours trawling the internet. I felt in the dark and worried about my ability to continue to run my own business successfully. Many of the working women I’ve interviewed about their experience of menopause have shared similar concerns with me, as well as worry they might be showing signs of dementia.
That was three years ago. Since then brain fog has become more readily acknowledged as one of the possible symptoms of menopause. And finally, it has become the focus of serious research.
Caroline Gurvich, Associate Professor, Department of Psychiatry at Monash University and Head of the Cognition and Hormones Group, has a particular interest in women’s brains during midlife. She is currently researching cognition during menopause and kindly gave me some of her time to answer my burning questions, that I wish I could have asked her three years ago.
How common is brain fog during menopause?
Approximately two thirds of women will experience some degree of cognitive difficulty at a subjective level. This could include difficulty learning and remembering information you have heard (verbal memory), quickly retrieving words from your memory (verbal fluency) and sustaining attention.
Some research verifies there are indeed objective subtle changes, but not to the extent that it would be classified as mild cognitive impairment (MCI).
Even if the changes are subtle on formal testing, this can still have a substantial impact on women’s daily life, especially their workplace performance and confidence.
Will my cognition improve post-menopause?
Studies are limited but the few longitudinal studies that have followed the trajectory of cognitive change over time generally find that our cognition bounces back, but it is highly individual.
During the time that the menopause transition takes place (eg between 45 and 55) ageing may also be having an effect. As we get older both men and women start to experience slower processing speeds and memory challenges. Cognition may therefore not ‘bounce back’ to pre-menopausal levels, but to a level normal for age.
What causes these cognitive changes during menopause?
Fluctuating and dropping levels of ovarian hormones play a key role.
During perimenopause, it seems to be the fluctuations in hormone levels that make it more difficult to think clearly. In the later stages of menopause, the eventual loss of oestradiol ( a potent type of oestrogen) is thought to be responsible for cognitive difficulties, since oestrogen plays an important role in protecting the brain, memory and learning.
Brain fog is often explained away as a secondary effect of other symptoms, such as depression, insomnia and hot flushes, however cognitive symptoms do occur in the absence of other menopausal symptoms.
Will Menopause Hormone Therapy (MHT) help?
You would think that if loss of ovarian hormones play a key role in worsening cognition, then replacing these hormones should help. However it’s not that simple. Research to date is suggesting that MHT does not appear to have a beneficial effect on cognition.
MHT is helpful for other symptoms so it can have an indirect benefit, by improving sleep for example.
How can I tell the difference between menopause brain and dementia?
If you keep struggling to remember where you put your phone or your car keys, or to remember an appointment, try bringing all your attention to the task at hand and be very focussed. (Sometimes distraction is the real problem.) If you still can’t perform the task, then see a doctor and have it checked out.
Forgetfulness and other cognitive difficulties during the menopausal transition are common and a normal part of menopause. Dementia that begins before age 65 is not common in the absence of a family history.
What will help my brain?
Exercise! It’s proven to improve cognition in mid-life. Having a practise that helps keep your attention in the present moment, such as mindfulness, also supports brain function.
A Mediterranean diet, lowering stress, positive social connection and challenging the brain with engaging, stimulating activities, have all been related to better cognition.
After speaking to Caroline, I have definitely felt more relaxed about my changing brain, and am noticing my cognitive strengths as well. These include stronger pattern recognition, due my life experience, as well as not sweating the small stuff as much. And relaxing is key since anxiety will impair cognition even further.