Menopause is a natural phase in a woman's life that is marked by various physical and mental-emotional changes that occur with the decline of ovarian function, and subsequently the decline in estrogen and progesterone. While hot flashes and night sweats are commonly associated with menopause, many women also experience cognitive changes, mood swings, and brain fog during this period. In his article I will review the relationship between menopause, mood, and cognitive related symptoms, and will provide a step-by-step guide for optimizing brain health during this phase of life.
Understanding Cognitive Changes in Perimenopause and Menopause:
Midlife women frequently report changes in cognitive function as they transition through menopause. These cognitive changes can include difficulties with memory, attention, concentration, and word recall. This constellation of symptoms is commonly referred to as "brain fog." However, it is essential to note that experiencing cognitive changes during menopause does not necessarily imply the development of a more severe cognitive disorder like dementia.
Research shows that the cognitive domains most affected during the transition through menopause are verbal learning and memory. Women may struggle with remembering words and numbers, misplacing items, trouble concentrating, and forgetting appointments. While these symptoms can be distressing, they are generally within the normal range and should not be confused with dementia.
Hormonal Influence on Cognition and Mood:
Estrogen, one of the key reproductive hormones that decline during menopause, is believed to play a role in mediating menopause-related cognitive changes. Studies suggest that estrogen receptors in the brain are involved in cognitive processes such as memory and attention. The decrease in estrogen levels may contribute to cognitive difficulties experienced during menopause.
Apart from the direct effects on estrogen on the brain, other menopausal symptoms like vasomotor symptoms (hot flashes and night sweats) are known to contribute to sleep disturbances and depressive symptoms in menopause. Both sleep disturbances, and mood changes can influence cognitive function, and these factors collectively contribute to cognitive difficulties during this phase.
Managing Cognitive Changes in Menopause and Optimizing Brain Health: A Step-by-Step Guide
Understand what cognitive changes are and how they manifest during menopause. Cognitive changes refer to a decline in cognitive function, such as memory loss, difficulty concentrating, and struggling to recall words and numbers.
Recognize that menopause-related cognitive changes are common, but not everyone experiences them. It is important to normalize the experience and be reassured that cognitive changes do not necessarily mean they are on the path towards dementia.
Consider hormone therapy as a treatment option, specifically if you have vasomotor symptoms that are contributing to sleep and mood disturbances. Estrogen plays a vital role in cognitive function, and hormone therapy may improve cognitive function in some women. Discuss the risks and benefits of hormone therapy with your healthcare provider to determine if it's the right option.
Address other potential modifiable risk factors for cognitive decline, such as poor sleep, lack of exercise, smoking, high blood pressure, prediabetes/diabetes, high cholesterol, thyroid disorders, nutrient deficiencies (ie. vitamin B12 and iron) and depression and anxiety. Incorporate healthy lifestyle changes that can help improve brain function, such as regular exercise, a healthy whole foods diet, and getting enough sleep.
Prioritize mental and social stimulation as a way to stimulate the brain and promote cognitive health. Examples of mental stimulation include reading, puzzles, and learning a new skill. Be mindful of staying socially active, whether that be through volunteer work, hobbies, or spending time with friends and family.
By taking these steps, I hope you can be empowered to take control of your cognitive and brain health during menopause.
It is essential to work with a healthcare provider who has expertise in mid-life health to help determine the best course of action based on your risk factors and health history. If you would like to learn more, please book a naturopathic appointment at Juniper Family Health. We are here to help!
In health and happiness,
Dr. Meghan van Drimmelen, ND | Naturopath Victoria BC
References:
The 2022 hormone therapy position statement of The North American Menopause Society
Psychiatric and cognitive manifestations of hypothyroidism
UpToDate: Clinical Manifestations and Diagnosis of Vitamin B12 and Folate Deficiencies
Anemia and the Risk of Cognitive Impairment: An Updated Systematic Review and Meta-Analysis