Note: October is World Menopause Awareness Month. The IMS (International Menopause Society) has designated “Mood and Cognition” as the annual theme for World Menopause Awareness Day, which is recognized on October 18th. The purpose of World Menopause Awareness Day is to create awareness and emphasize the importance of managing menopausal symptoms like brain fog and memory problems.
Menopause transition brings a wide range of symptoms that not just affect our menstrual cycles but also our bones, skin, and even our brain. It’s common for women to experience brain fog, mood swings, reduced memory, and other symptoms that point to disruptions in the cognitive functions of the brain, during perimenopause and into post-menopause. The impact of hormonal changes on mood and cognitive function during menopause transition can be mildly irritating to seriously disruptive.
Menopause: A Neurological Change
Loss of cognitive functions including reduced memory and brain fog are more commonly linked to the age-related degenerative changes occurring in the brain as a part of aging, than to menopause transition. However, studies have found that brain fog and memory loss can also occur due to hormonal changes occurring during menopause:
- Nearly two-thirds of women experience cognitive difficulties, especially memory problems, during the menopausal transition. They may also experience symptoms of brain fog, like language and attention deficits.
- Cognitive complaints like confusion, mood swings, poor decision-making skills, and the inability to maintain focus are preceded by changes in hormone levels, particularly estrogen. This suggests that menopause transition is not just a period of hormonal change but neurological change as well.
The common neurological changes occurring during menopause include brain fog, reduced memory, forgetfulness, altered mood, difficulty in concentration, reduced focus, sleep disturbances, and hot flashes.
Impact of Menopause on Brain Function
Brain Fog
Brain fog refers to the range of cognitive issues commonly associated with aging as well as menopause. It primarily includes forgetfulness and difficulty concentrating. These symptoms are often related to “menopausal fatigue” and are exacerbated by insomnia and night sweats.
Brain fog during perimenopause occurs due to fluctuations in the production of the female reproductive hormones estrogen and progesterone.
It can lead to symptoms such as:
- Difficulty remembering words and numbers
- Forgetting important appointments or events
- Disruptions in performing routine activities
- Difficulty concentrating
- Absent-mindedness
- Being easily distracted
- Inability to switch between tasks easily
Forgetfulness
Studies have shown that forgetfulness and memory loss during menopause transition can significantly affect our quality of life. Forgetfulness is often linked to deficits in attention, reduced information-processing speed, and reduced memory.
A study published in the American Journal of Epidemiology revealed that nearly 31% of pre-menopausal women experience forgetfulness. The risk of cognitive decline increases during menopause transition with nearly 44% of women in early perimenopause and 41% of women in post-menopause experiencing these symptoms.
Difficulty Concentrating
Difficulty concentrating is another symptom that points to cognitive disruption due to fluctuating hormones.
The reduction in estrogen levels during menopause leads to changes in the structure and number of nerve cells. It even modifies the interactions between these cells. This can create an adverse impact on the utilization of glucose as a source of energy by the nerve cells.
The inadequate availability of energy in the form of glucose is implicated as one of the factors responsible for the loss of cognitive functions, especially difficulty in concentrating, in menopausal women.
Studies have shown an association between difficulty in concentrating and the reduced ability for verbal learning and remembering important things in menopausal women. In clinical practice, these cognitive changes are also observed to affect the daily activity of women.
Distinguishing Between Menopausal Brain Fog, Dementia, and Alzheimer’s
A decline in the cognitive functions of the brain is primarily attributed to the degenerative changes that occur in the brain as a part of aging. This is one of the reasons why the cognitive disruptions caused by menopause are often ignored or even misdiagnosed.
Distinguishing between the causes of cognitive disruptions, such as menopause transition, or degenerative conditions such as dementia and Alzheimer’s, is essential to be able to receive the most appropriate treatment.
Here are some points that can help differentiate between these conditions and enable correct diagnosis:
- Cognitive disruption tied to menopause begins at a much earlier age in women. Reduced memory, brain fog, and difficulty concentrating in women in their 40s or 50s are more likely to be due to menopause transition.
However, if these symptoms occur after the age of 60, they are likely to be due to degenerative changes linked to dementia and Alzheimer’s.
- Menopause-linked cognitive decline is often associated with other signs such as hot flashes, severe mood swings, increased sweating, and sleep disturbances. These symptoms are likely to be absent or occur at a very low intensity when they are attributed to dementia or Alzheimer’s.
Treatment of Cognitive Decline in Menopause
Menopause Hormone Therapy
Hormone therapy aimed at restoring the balance of hormones in the body can provide significant relief from the symptoms of cognitive decline and disruption during menopause transition.
Initiation of hormone therapy early on during perimenopause or about four to six years before menopause may also prevent the symptoms from developing. Early initiation of hormone therapy can create a significant positive effect on brain activities, thus improving the decision-making skills as well as the quality of life of women.
Meditation
Meditation and yoga have been found to be highly effective in restoring the balance of hormones in the nervous system.
These simple strategies can provide relief from the symptoms of cognitive loss such as reduced memory, brain fog, and difficulty in concentration. Moreover, meditation and yoga can also relieve the other signs of menopause such as increased sweating and hot flashes while improving the quality of sleep.
Healthy diet
Adopting healthy dietary habits has been shown to produce a direct beneficial effect on the brain at the level of cellular activities. Dietary habits like increasing the intake of fruit, whole grains, and foods that contain a rich amount of proteins, vitamins, minerals, and omega-3 fatty acids can also have a beneficial effect on memory function.
Improve sleep
Adequate sleep plays a critical role in improving overall health and maintaining a favorable balance of hormones in the body. Adequate sleep is also essential for restoring optimal brain function.
During perimenopause, it’s recommended that you get at least 8 hours of sound sleep every night to improve hormone balance and enhance cognitive function.
Conclusion
Cognitive complaints are very common during perimenopause. These symptoms tend to occur due to the reduction in ovarian functions, and a progressive decline in the secretion of estrogen.
Proper diagnosis of the underlying cause by differentiating these symptoms from those related to dementia and Alzheimer’s is essential for receiving the most effective treatment.
The good news is that Brain Fog and other cognitive disruptions can be managed effectively through hormone therapy and/or lifestyle modifications such as eating a nutritious diet, getting adequate sleep, and practicing mindfulness.
References:
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8394691/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3762921/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8394691/
- https://www.neurores.org/index.php/neurores/article/view/594/561
- https://pubmed.ncbi.nlm.nih.gov/31581598/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6119544/
- https://pubmed.ncbi.nlm.nih.gov/10981461/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8394691/
- https://pubmed.ncbi.nlm.nih.gov/21716773/
- https://www.health.harvard.edu/blog/menopause-and-memory-know-the-facts-202111032630