The Menopause and

Hot flashes and night sweats get all the attention when it comes to menopausal symptoms, but for many women, it's the way perimenopause and menopause affect their brain that's a bigger priority. 

Mood swings, anxiety, depression, insomnia and "brain fog (a combination of confusion, memory loss, and inability to focus)," are common complaints during menopause. Women in their 40s and 50s who should be at the top of their game, find themselves dropping the ball, making small errors and forgetting details like never before. 

What's causing them to lose their edge?  It's the body's reaction to not getting the supply of estrogen and progesterone it is used to.  Women have estrogen and progesterone receptors all over the body, not just in their reproductive organs. When these receptors are no longer fueled with reproductive hormones, they respond by altering the way neurons fire.  Toss in fatigue from too many sleepless nights, and it's no wonder some women experience brain fog.

Desiree Bley MD, Portland OR OB-GYN says, "Three things happen during perimenopause and menopause that cause women's brains to process information differently:

1)  "Women expand their focus in order to manage everything-children, careers, families, and more. They aren't really losing brain function; they're just at a point where there's too much on their plate and some things are falling off."

2) "Estrogen levels decline but our androgens (male hormones) stay the same.  Though we've always had these hormones, we're used to functioning with our estrogen as dominant.  We're not used to having our androgens run all our machinery. Women come to me and say they're getting hairy, angry, and forgetful.  I tell them, 'Welcome to your male hormones.'  This is the way men operate all the time."

3) "Chronic sleep deprivation-whether it's caused by hot flashes, kids waking you up, or a spouse who snores, sleep deprivation accumulates. Our brains can only take so much.  The key is finding better sleep."

Researchers at UCLA studied more than two thousand women between ages 42 and 52 for four years (during pre-menopause, early perimenopause, late perimenopause and after menopause). They tested their verbal memory, working memory and processing speed and confirmed that during the five or six years leading up to their last period, women do indeed, lose their intellectual edge.

The good news is once menopause is over, most women rebound and their brainpower returns to normal.  Researchers also found that women who began hormone replacement therapy before having their last period experienced cognitive improvement but those who began after their last period did not.  Dr. Bley agrees, "When women add a little estrogen back, they often say, 'I've got my brain back.'"

Whether you choose hormone replacement therapy or not, all women benefit from exercise, stress reduction techniques like meditation, and improving their diet. In addition, try these tips for staying on top while you're waiting for your post-menopausal rebound.

  • Don't wait. Carry a note pad or digital recorder and jot down ideas and reminders as soon as you think of them.
  • Write out your daily schedule, appointments and chores. Even if you keep an electronic calendar, putting pen to paper acts as a powerful reminder.
  • Take advantage of technology. Your cell phone, computer and other electronics are perfect tools for keeping information organized though most of us only use a fraction of their capabilities. Take a class or get a tech-tutor to bump up your computer-geek skills.
  • Make sleep a priority. Many women have success using acupuncture, over-the-counter and/or prescription sleep aids.
  • Clear your plate. Simplify your schedule, delegate chores, and designate more time to rest, recharge, and reward yourself for all you accomplish.