Menopause, Memory, and the Mind
Recently, a friend was waxing philosophical about the luck of someone who had won the lottery. Suddenly, she stopped talking and furrowed her brow as she groped for the word she was looking for.
"Random," I offered.
"Yes! That's it!" she declared. After pausing again, she suggested that menopausal women would benefit from traveling in pairs just so they could finish each other's sentences.
If you're going through menopause -- defined as not having menstruated for a year -- you may have frequent moments when the word you're searching for escapes you. Or you may walk into a nearby room to do something, only to realize you have no idea what it was you intended to do.
In fact, it's not uncommon for women to experience a whole list of puzzling memory and reasoning problems around the same time they're going through menopause. So if you're in menopause and worried about fuzzy thinking, groping for words, or feeling forgetful, don't despair. You're not alone, and there are ways to manage those troublesome mental blips.
Do hormonal changes affect how the brain works?
Research shows that the female sex hormone, estrogen, plays a key role in brain function. An article in the journal Neurology describes estrogen as "a key element in the work of the brain [that] helps direct blood to parts of the brain that are more active." That hormone declines during menopause, but that doesn't mean your brain function will decline along with it. According to a six-year study of women who were still menstruating, perimenopausal, or postmenopausal, most of the women improved their test scores of brain function over time. That is, even women with declining estrogen were able to improve brain function.
One of the ways that researchers have tried to document how the downward shift in estrogen production affects memory is by studying women who've experienced sudden menopause as a result of the surgical removal of their ovaries. Studies have associated subsequent memory problems with a loss of estrogen, but it's not really clear how strong that link is.
In one study, for example, women's memory and reasoning skills were tested before and after they had their ovaries surgically removed. On tests of their short- and long-term memory and logical reasoning skills, study participants who were not taking hormones after surgery had lower scores than women who underwent the same surgery but were treated with hormones. But reviewing this study, surgeon and breast cancer expert Susan Love, MD, writes that the study subjects were tested only three months after surgery -- too short a time for the results to be conclusive. And, she adds, "We don't know if the effect of hormones on someone thrown abruptly into menopause is the same as on someone who has a natural, more gradual menopause."
Although estrogen produced by our bodies helps the brain function, there's no clinical evidence to support the notion that the brains of women after menopause don't work as well. One need only take a look at women like Marie Curie or Margaret Mead, who were both actively involved in their scientific careers well into old age. In fact, Mead is reported to have said, "There is no more creative force in the world than the menopausal woman with zest."
Are there ways to improve memory and thinking?
If postmenopausal women have memory slips or difficulty concentrating, research suggests a variety of potential underlying causes. These include disturbed sleep, extra stress, or depression. If you're awakened by night sweats several times during the night, that's often enough to interfere with your ability to concentrate or remember what tool you were trying to find in the garage the next day.
Should hot flashes be the reason for your insomnia and the fuzzy thinking and memory glitches that follow a sleepless night, try reducing their hold on you with some lifestyle changes. Exercising daily is linked to a lower incidence of hot flashes. And if you're a smoker, this may be the motivation you need to finally quit: Women who smoke have more intense and more frequent hot flashes than nonsmoking women.
If you think you might be depressed, which can cause difficulty concentrating, make an appointment with your doctor. Feeling occasional sadness isn't the same as being depressed. Depression is feeling sad or lacking interest in previously enjoyed activities for two weeks or longer, with at least four of the following occurring nearly every day: depressed mood, loss of interest in activities; significant change in weight and appetite; significant change in sleep; feeling physically restless or slowed down; fatigue or lack of energy; feeling worthless; diminished ability to think or concentrate; recurrent feeling of wanting to die or attempting suicide.
If your stress quotient is noticeably high, you may be able to rein it in by practicing some form of relaxation. One of the simplest ways to combat stress is deep breathing. Meditation, yoga, tai chi, or gentle stretching are also good ways to reduce stress. If stress, memory slips, or other menopausal symptoms continue to bother you, consult your doctor. The key is to take action that will let you feel more in control.
Now what was I saying?
Love, Susan M., with Karen Lindsey. Dr. Susan Love's Menopause & Hormone Book. Three Rivers Press, 2003.
Boston Women's Health Book Collective. Our Bodies, Ourselves. Simon and Schuster, New York 2006.
Thompson, Russel L. "Menopause and brain function." Neurology, 2003; 61; 9-10, p. E9.
Sherwin, B.B. "Estrogen and/or androgen replacement therapy and cognitive functioning in surgically menopausal women." Psychoneuroendocrinology, 1988;13(4):345-57.
"Marie Curie and The Science of Radioactivity." American Institute of Physics, http://www.aip.org/history/curie/radinst2.htm.
"Margaret Mead." www.amnh.org/exhibitions/expeditions/treasure_fossil/Treasures/Margaret_Mead/mead.html.
Mangione, Carol M., Deborah Briceland-Betts, et al. "National Institutes of Health State-of the-Science Conference Statement: Management of Menopause-Related Symptoms." Annals of Internal Medicine, Vol. 142, Number 12 (Part 1), June 21, 2005, pp 1003-1013 (NIH), p. 1006.
Li, Cairu, Wilawan, Kittisak, et al. "Health profile of middle-aged women: Women's Health in the Lund Area study." Human Reproduction, 17 (5): 1379-85, May 2002.
Bosworth, H.B., L.A. Bastian, et al. "Depressive Symptoms, Menopausal Status, and Climacteric Symptoms in Women at Midlife." Psychosomatic Medicine, 63: 603-608 (2001) p.604.
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. American Psychiatric Association, 2000.
Mayo Clinic. "Hot flashes: minimize discomfort during menopause."