Menopause and memory loss


Alzheimer’s, Memory Loss, Dementia, and Menopause

Have you recently forgotten a friend’s name or where you left your keys? If so, you’re not alone. Most middle-aged women experience lapses in memory from time to time, especially before or during menopause.

At least half of Americans over the age of 65 say they’re more forgetful now than when they were younger, according to the Fisher Center for Alzheimer’s Research Foundation.

Usually, lapses in memory can be attributed to normal aging, but sometimes they can be a sign of dementia or Alzheimer’s. Dementia is a general term that means a loss of memory that interferes with daily activities. Alzheimer’s disease is the most common type of dementia, marked by severe memory and functioning problems, and which can eventually lead to death. Like other forms of memory loss and dementia, Alzheimer’s is caused by changes in the brain.

According to the Alzheimer’s Association, Alzheimer’s accounts for an estimated 60 to 80 percent of dementia cases. It’s a progressive disease, meaning it worsens over time. Some other types of dementia include Parkinson’s disease and Huntington’s disease.

The difference between occasional forgetfulness and these serious memory problems isn’t always so clear. Read on to learn when it might be time to ask for help.

What’s normal?

As people age, many changes affect how different parts of the body function, including the brain. Chemical and physical changes in the brain can make it more challenging to learn new skills, more difficult to remember information accurately, and more likely that things, such as a pair of glasses or an item on a grocery list, will be forgotten.

One major change to the body that may cause normal forgetfulness during menopause is a reduction in the body’s hormone levels. Estrogen is one major hormone that can impact memory before or during menopause. It has a role in regulating a variety of brain chemicals, along with many functions of the nervous system.

As your body’s estrogen levels decrease, which happens before and during menopause, estrogen can no longer participate in brain function as it normally had. This can cause occasional lapses in brain function, resulting in short-term memory issues. This decrease in estrogen can also lead to anxiety, depression, hot flashes, and sleep disturbances, conditions that may contribute to memory problems.

How can I improve my memory?

Occasional fogginess and forgetfulness may be a result of normal aging, but even so it can be frustrating to live with. Clinical studies suggest that replacing some of the natural hormones lost before and early on in menopause may help reverse some of the memory-loss problems women normally experience as they age.

If your memory problems are interfering with your quality of life, you may want to consider discussing hormone replacement therapy (HRT) as an option with your doctor.

The goal of HRT is to provide a short-term solution to slow some of the major changes to the body that occur during menopause. Taking low doses of estrogen, and sometimes estrogen combined with another hormone called progesterone, can lessen the intensity of menopausal symptoms, such as:

  • forgetfulness
  • hot flashes
  • night sweats
  • mood swings

HRT can also help strengthen bones, which naturally become weaker with age.

Estrogen isn’t intended as a long-term solution to normal memory problems attributable to aging. This is because it can increase your chances of developing other conditions, such as:

  • heart disease
  • stroke
  • blood clots
  • breast cancer

The role of HRT in dementia is unclear. Research shows conflicting results as to whether it may lead to or protect against dementia. Additionally, HRT isn’t recommended for women who have a history of:

  • certain cancers, such as breast and ovarian cancer
  • blood clots
  • strokes

There are also other medical conditions that may make HRT not the best choice of treatment. Talk to your doctor about whether HRT is right for you.

At-home memory boosters

Whether or not you decide to use HRT, there are some easy ways to help improve your memory at home. Experts say aging women can help keep their brains working at their best by constantly “exercising” their minds. You can do this by:

  • solving crossword or other types of puzzles
  • playing an instrument
  • participating in team sports
  • reading
  • writing
  • learning a new language

Try to challenge your brain in as many ways possible.

Because stress can also hurt your memory, it’s a good idea to try stress-reducing activities, such as:

  • meditation
  • yoga
  • relaxation techniques
  • tai chi

In fact, a 2012 study has shown that practicing tai chi three times a week can improve results on thinking skills and memory tests.

A health-conscious lifestyle can boost your overall health, which can also improve your memory. Incorporate activities into your life, such as:

  • adequate sleep
  • regular exercise
  • healthful eating

When should I ask for help?

The various types of dementia, including Alzheimer’s disease, often have a slow onset. This makes it hard to tell what’s normal memory loss due to aging and what’s a serious problem. The Alzheimer’s Association has outlined the major differences:

Symptoms of dementia:

  • routine lack of judgment and poor decision-making
  • inability to pay bills, handle money, or make a budget
  • forgetting the day of the week, date, month, year, or season
  • having trouble carrying out a normal conversation
  • losing items and being unable to find them

Normal age-related memory problems:

  • making a poor decision occasionally
  • missing a monthly credit card payment once in a while
  • forgetting the day of the week or date and remembering later
  • sometimes having trouble remembering a word or name during a conversation
  • misplacing things occasionally but finding them later

Other symptoms of more serious dementia, such as Alzheimer’s disease, include:

  • difficulty making plans or solving problems
  • problems carrying out usual tasks at home, work, or during recreation
  • confusion with time or place
  • trouble comprehending visual images and spatial relationships (such as depth and distance)
  • new problems with speaking or writing
  • a lack of interest in work or social activities
  • prolonged changes in personality or mood

See your doctor right away if you recognize some of the signs of dementia or Alzheimer’s disease in yourself or someone you care about. Detecting a serious memory problem early helps increase your chances of living a fuller and healthier life.

Menopausal Memory Loss and Brain Fog (Fact Sheet)

I am constantly saddened by my patients telling me stories about how the menopause affects their quality of life. Women I talk to are generally not coming to my menopause clinic complaining primarily about their hot flushes or night sweats; it is the effects of low oestrogen on their brains that has the biggest impact on how they are living.

I see many women who are worried they have dementia as they have a worsening memory and are constantly forgetting things. It can be quite amusing when you find your car keys in the fridge but it is not amusing when you forget to go to an important event or cannot remember details of a work meeting.

The main female hormones oestrogen and testosterone have an important role to play on cognition and memory. When these levels reduce during the perimenopause and menopause, many women find that they have numerous symptoms affecting these functions.

A recent questionnaire undertaken by West Midlands police revealed that around 80% of women had symptoms related to the menopause that interfered with their ability to work. The three most common symptoms that were affecting them were memory problems, fatigue and anxiety.

I have seen women who tell me they have forgotten important appointments, that they are making very important mistakes in their work and other women tell me they are constantly forgetting their children’s games kit to take to school. All of this is very frustrating and can affect not just the women but people close to them too.

The average age of the menopause in the UK is 51 years but around 1 in 100 women have an premature menopause (under 40 years). Many of these women are still not receiving adequate help, support and advice about how best to manage their symptoms. In addition, so many women do not realise that their symptoms are related to their menopause.

Talking to most women about the menopause, they always think about hot flushes and night sweats. However, many women, including Kate Reddy and Allison Pearson’s fantastic novel How Hard Can It Be, blame their symptoms on their stressful lives and being pulled in various directions, often by children and elderly relatives. They often have no idea the psychological effects of the menopause.

One of the most common problems people who see me in my menopause clinic complain of is interrupted sleep. Having disturbed sleep has a huge impact on how women feel the following day. Many women tell me they wake up feeling exhausted and they drag themselves around during the day. Women tell me they have no energy or motivation to do their daily tasks let alone do any exercise.

Brain fog is a very common symptom of the menopause and women have told me that their brains feel like “cotton wool” and they find it very difficult to absorb information. This can be a challenge with high-powered jobs but it can also affect simple tasks like reading a book or listening to the radio.

There has been so much negative publicity in the past about HRT that women are scared of taking it. However, we have clear guidelines based on the available evidence which support the safety of HRT. The majority of women taking HRT find that their motivation, energy, focus and memory really improve. This has a very beneficial effect on the quality of life but also their ability to function and work.

Many employers underestimate the very negative effect the menopause can have on women. I work very closely with West Midlands Police and it is very clear that these women do not want to simply be offered fans or to work with better air-conditioning. What they need is for other people to appreciate and understand the numerous symptoms that can affect women at this stage of their lives.

Women also need better access to menopause care so they can be offered the right dose and type of HRT. Both oestrogen and testosterone are very important female hormones that need to be balanced correctly for women to function better. In addition, taking HRT can lower future risk of diseases such as osteoporosis and cardiovascular disease.

Last updated: February 2018

Menopause and memory lapses

Eileen talks about: Memory lapses


An introduction to memory lapses and menopause

Memory lapses occur when you momentarily forget everyday things such as where you put your pen down, the date of an appointment or what your next door neighbour is called. This can be irritating, sometimes embarrassing and often worrying.

Going through the menopause may cause you to have difficulty concentrating or make your brain freeze as you grope into its depths trying to remember what time to pick up your child from football practice. Memory lapses affecting menopausal women tend to hinder short-term memory rather than cause you to forget major events from your past.

Why does menopause cause memory lapses?

Menopause disrupts the balance of hormones in your body. At the same time, your brain contains oestrogen receptors and is responsive to this hormone, helping your brain function better, aiding memory and verbal fluency. When levels of oestrogen in your body drop, it is no wonder that you may suffer unexpected lapses in memory.

There is also research to suggest that frequent hot flushes can result in lapses in your memory. Night sweats can prevent you from getting a sound night’s sleep, which hinders focus and recall the next day.

It is worth remembering that memory lapses, like other menopause symptoms you are experiencing, should not last. The research holds out hope that once you are through the menopause, you will be able to recall information more effectively again.

However, if you are suffering from continued, severe or worsening memory symptoms, rather than mild memory falters, then it is necessary to seek advice from a doctor to rule out any underlying health issues.

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What home remedies are there for memory lapses?

There are certain measures which you can slip into your day-to-day routine (if you remember!) which can help boost your memory:

  • Exercise – regular exercise will maintain a rich blood flow around the brain. This will keep your brain cells healthy and reduce your likelihood of memory lapses
  • Drink plenty of water – water hydrates the body and brain, keeping them healthy
  • Mind games such as sudoku and crosswords – keeping your brain active through games or learning a new skill will stimulate your brain to make new connections
  • Eat a balanced diet – a healthy diet is one of the primary ways of keeping your body healthy. Certain foods have been shown to improve mental function, so including these in your diet should help with your memory lapses. These include fish, soy products and fruit and vegetables
  • Taking a supplement of soya isoflavones mimics the action of your natural hormones and can have the benefits HRT provides without the side-effects
  • Vitamin B – taking a vitamin B complex supplement can also aid your mental function and help prevent lapses in memory
  • Make sure you sleep well – if you don’t sleep at night, and spend your waking hours tired, your ability to remember information will reduce. Getting a proper amount of sleep at night has been proven to increase your mental function and concentration during the day. If you have trouble sleeping at night, our sleep hygiene tips page may help
  • Relax – it is important to take time every day to relax. If you begin to panic when your brain denies you information, this will only make the situation worse.

Are there herbal remedies to help me?

Menopausal women often look to herbal remedies to help with their memory lapses. Herbs which are useful during this time of life include:

Ginkgo biloba – this is about the oldest medicinal herb around, dating back to 3,000 BC. Its nickname of ‘memory tree’ indicates its properties

Salvia Officinalis – this herb is also known as sage and is commonly used to treat hot flushes associated with the menopause and alleviate the symptoms of night sweats, Research has also shown that it can help the brain function better

Rosemary – the ancient Greeks used rosemary to improve memory and it is still thought today that inhaling its fragrance can aid your memory.

Concentration Essence – this contains a number of flower essences designed to improve concentration. It can be taken on the spot if you are struggling to focus.

What about conventional remedies?

Memory lapses related to the menopause tend not to linger once you are through this time of life. This means that there are no drugs specifically designed to help with your menopausal memory lapses which your doctor can recommend.

If you are suffering from more long-term memory loss and you begin to forget things which you have known for years, then it is best to seek medical advice.

Women in their 40’s and 50’s experience menopause as a natural part of life. Along with the well-known symptoms of hot flashes and weight gain, many women report forgetfulness and difficulty concentrating. It is believed this “brain fog” is caused by changes in estrogen, progesterone and possibly other hormone levels. Heather Bimonte-Nelson, Ph.D., studies the link between memory loss and menopause in her laboratory at Arizona State University.

“We know that women are at a higher risk of developing dementia and Alzheimer’s disease than men,” says Dr. Bimonte-Nelson, a researcher and psychology professor. “Why is that? One reason could be the dramatic change in hormone levels that occurs during menopause.”

Dr. Bimonte-Nelson is researching the impact of both natural menopause and menopause caused by surgical removal of the uterus and/or ovaries in rat studies. She and her team have shown that the natural transition to menopause is a particularly sensitive time of memory change in rat models. This finding builds on studies showing similar memory challenges in women as they move into menopause. Some types of hysterectomies can cause menopause to begin early and can also be accompanied by memory issues. It has yet to be determined which specific reproductive tissues contribute to these effects.

It has long been thought that the uterus has no function outside of pregnancy. Dr. Bimonte-Nelson and her team are debunking that theory. “Our recent study results show that a female’s reproductive organs have value beyond pregnancy,” says Dr. Bimonte-Nelson. “When we removed the uterus but kept the ovaries, the rats experienced memory impairment, especially when having to remember numerous items of information.”

There is some research that shows women who have had a uterus-only hysterectomy can experience an increased risk of dementia if the surgery happened before natural menopause. The question is why does removing the uterus alone have an impact on cognitive function?

“We know that the transition to menopause, whether natural or surgically-induced, can lead to changes in memory and thinking,” explains Bimonte-Nelson. “We are now evaluating the type of memory changes that are most extreme and how the uterus plays a role.”

Dr. Bimonte-Nelson wants to provide women with knowledge about menopause and how to best prepare for this stage in life. While we know menopause can cause memory and thinking problems, she states further research is needed to better understand why.

If you have questions about menopause, Dr. Bimonte-Nelson recommends spending some time on the North American Menopause Society website. It offers excellent updated and detailed information about menopause and staying healthy in midlife.

WEDNESDAY, Nov. 9, 2016 (HealthDay News) — Middle-aged women can remember more than men their own age, but new research suggests that memory may fade as estrogen levels drop during menopause.

Memory loss is a common age-related complaint, affecting up to 75 percent of older people, the study’s authors explained. The researchers noted that many women going through menopause report being more forgetful, though they still outperform men on memory tests.

“Brain fog and complaints of memory issues should be taken seriously,” said Dr. JoAnn Pinkerton, executive director of the North American Menopause Society (NAMS).

“This study and others have shown that these complaints are associated with memory deficits,” she said in a society news release.

The study by Harvard Medical School researchers was led by Jill Goldstein, a professor of psychiatry and medicine. It included 212 men and women, between 45 and 55 years old. For the study, Goldstein’s team used memory and thinking tests to rate the memory, executive function, word processing and verbal intelligence of these adults.

The study found that women who had gone through menopause had worse memory than those who had not gone through menopause. A drop in estrogen levels among older women was associated with lower rates of learning new information and recalling memories, the researchers said.

Memory storage and consolidation, however, weren’t affected, the study authors said.

The study findings were published Nov. 9 in the journal Menopause.

wundervisuals/Getty Images

You can’t remember where you put your keys, and you found your phone in the fridge. You may automatically leap to the conclusion that you have Alzheimer’s, but there are a few much more likely reasons for your memory loss.

Possible reason: Perimenopause/menopause

How it affects memory: Your body is making less estrogen, which affects the brain because its hormone receptors are involved with memory, says Raymond Oenbrink, a family physician with Appalachian Wellness in Asheville, North Carolina. A recent study found that hormone changes during perimenopause may cause a decline in verbal memory; and another study published last year shows that it’s harder for women to learn during perimenopause.

Do you have it? Perimenopause generally begins in your mid-40s, but it can start in your late 30s or early 40s. Symptoms include varying cycle lengths, hot flashes, night sweats and insomnia.

How to get your memory back: After menopause, your memory should improve, the study says. But if you’re still having issues, Oenbrink recommends hormone replacement therapy or bioidentical hormone replacement therapy (speak with your doctor about the side effects of both).

Possible reason: Vitamin B12 deficiency

How it affects memory: This vitamin plays an important role in neurological function, says Edwina Clark, a registered dietitian in San Francisco. Deficiency can lead to neurological symptoms like confusion, poor memory and depression. At risk are older adults because stomach acid production decreases with age — and this acid is necessary to absorb vitamin B12 from food, Clark says.

Do you have it? If your skin is paler than usual, if you’re tired or weak, or if you have a “pins and needles” sensation, you should get tested for a B12 deficiency.

How to get your memory back: Vitamin B12 is primarily found in animal-derived foods and fortified foods (cereal, for example). You can also take a B12 supplement.

Possible reason: Depression

How it affects memory: A 2015 study found that depression leads to short-term memory loss. And another study found that people who were sad couldn’t identify objects that were similar to those they saw previously. “Depression, anxiety or any other mood disorder creates a background noise — running thoughts or emotions — that do not allow the information to land where it needs to land for proper processing,” says Ayesha Sherzai, codirector of the Alzheimer Prevention Program at Loma Linda University Health in California.

Do you have it? Clinical depression symptoms include hopelessness, irritability and a sad feeling that doesn’t ease.

How to get your memory back: The good news is, this isn’t permanent memory loss. When you feel better, your memory will be better. Depression-related memory loss can be managed with antidepressants and therapy. As always, talk to your doctor about possible remedies.

Possible reason: Stress

How it affects memory: Under short periods of stress, your body releases cortisol, norepinephrine and adrenaline to prepare itself for a threat, says Robert Zembroski, a chiropractic neurologist, clinical nutritionist and author of Rebuild. “Elevated stress hormones over time produce structural changes in the hippocampus that lead to memory disorders,” he says. The loss of neuron connections in your prefrontal cortex can add memory problems, especially as you age.

Do you have it? Headaches, insomnia, tense muscles and an upset stomach are all signs that you might have too much stress.

How to get your memory back: If you can’t get rid of all your stressors, there are other small changes you can make that can help, Zembroski says. These include getting seven to eight hours of sleep nightly, exercising daily and using association to remember things (create a visual for your brain, fixate on it, and associate it with whatever you’re trying to recall).

Possible reason: Low vitamin D

How it affects memory: This vitamin targets genes in the brain, and enhances neurotransmission (important for memory and executive function). Older adults aren’t as efficient at making vitamin D endogenously, and they’re more likely to spend time indoors (no more afternoons spent at the playground), Clark says.

Do you have it? If you are tired and often getting sick, and have excessive hair loss and muscle pain — get tested.

How to get your memory back: Vitamin D is produced via the skin through sun exposure or through foods naturally containing the vitamin, such as fatty fish (salmon and tuna) or fortified foods (milk and some cereals). You can also take supplemental vitamin D pills.

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5 Ways to Fight Memory Loss During Menopause

Menopause is a condition that has an abundance of anecdotal evidence. Half the human population is scheduled for this life-changing, body-changing condition, so there is plenty of experiential information from which to draw conclusions about the biological, psychological and social realities of menopause.

This study gives some independent credence to what many, many women can tell you: Menopause messes with your memory.

Menopause and Brain Fog

Researchers from the University of Illinois and Northwestern University in Chicago tested 68 women, ages 44 to 62, who had at least 35 hot flashes per week. Those women who reported struggles with memory, negative emotions and more troublesome hot flashes were the ones who did the worst on tests that measured memory. Intense menopause can mean intense memory muddling.

Dr. Daniel Amen wrote a book about the female brain. The book will help you end the confusion regarding hormones, get your cravings under control, no matter where you are in your cycle, and optimize your brain for love, sex and relationships. Plus, the book will help you get your brain ready for babies, and give you insight into how to raise them in a brain healthy way. It will give you 12 simple hour-long exercises to assess, train and strengthen your brain. It’s the only owner’s manual you will ever need for your female brain.

The menopausal brain is at the effect of enormous hormonal changes, and memory can be a casualty. Muddling can be due to decreases in progesterone, which can affect sleep patterns and increase anxiety. It can also be due to the natural decrease in DHEA, a precursor hormone to estrogen and testosterone that is highly protective in the brain, particularly its major learning and memory centers. The reality is that memory problems in menopause are likely a result of many factors.

Whatever the specific cause of memory trouble in menopause, there are some things that every menopausal woman can do to start taking control of the situation. Here are 5 of them from my book Unleash the Power of the Female Brain:

1. Love Your Female Brain

Think: Most people don’t think about their brain because they cannot see it. But to overcome challenges in every part of your body and life, you need to care about your brain more than any other body part.
Do: In all you do, start asking yourself, “Is this good for my brain or bad for it?”

2. Feed Your Female Brain

Think: There is simply no way around it. If your food is not the best, you will never be your best. Eat right to think right!
Do: Discover the best foods for your brain – stock up on them and eat them daily! Get to know The Omni Diet – it has your brain’s best interest at heart.

3. Sooth Your Female Brain

Think: Determine to put an end to anxiety, worry, depression, and perfectionism.
Do: Try The Amen Solution at home for a couple of weeks and watch your thinking turn around.

4. Balance Your Hormones to Boost Your Female Brain

Think: Hormones run your brain, and problems start when hormones fall into a state of imbalance.
Do: Follow brain healthy habits to naturally balance hormones. Talk to your doctor about bioidentical hormone replacement therapy (BHRT).

5. Get Control of Your Female Brain

Think: Conquer cravings, weight issues, and addictions.

  • Decide what you really want (define your goals)
  • Know your healthy behaviors (ask yourself what you need to get healthy, then practice those behaviors over and over)
  • Know your vulnerabilities (journal to keep track of good times and bad times during your day)
  • Learn to love what you hate (make the right choices pleasurable)
  • Turn accomplices into friends (friends support good habits, accomplices support bad habits)
  • Make your space work for you (surround yourself with healthy food and tools to support healthy habits)
  • Embrace your failures (learn from your mistakes and make a plan to break unhealthy patterns)

For women and men alike, as we age, we have less room for error when it comes to our brains. As women approach menopause it is even more critical to take brain health seriously. If you are concerned about menopause affecting your memory, contact Amen Clinics today online or call (888) 288-9834.

There was another especially interesting finding in the report, Dumas pointed out.

The one-third of postmenopausal women who scored highest on the memory tests actually had brain activity that looked like that of premenopausal women — despite their low estradiol levels.

Why is that?

“That’s the million-dollar question,” said lead researcher Emily Jacobs, who conducted the research while at Harvard and is now an assistant professor at the University of California, Santa Barbara.

“We’d like to understand why some women see changes around the time of menopause, and others do not,” Jacobs said.

It’s possible, she explained, that some women’s brains are somehow resistant to the effects of waning estradiol. Their brains might, for example, recruit estrogen from sources other than the ovaries — such as body fat or by converting testosterone.

“Or,” Jacobs said, “maybe it’s not estrogen at all. Maybe some women are resistant because of their exercise levels, or mental exercise levels, over a lifetime.”

That’s not to say that women who do go through brain fog have something to fear, Jacobs stressed. “We’re not trying to imply that menopause is pathological,” she said.

Pauline Maki, a professor of psychiatry and psychology at the University of Illinois at Chicago, agreed.

“This study is important for women because it helps to normalize their experiences,” said Maki, who was not involved in the research.

“Many women fear that the memory changes they are experiencing at this time might be a sign of Alzheimer’s disease or another cognitive disorder,” Maki explained. “These findings should give women reassurance that these changes are normal.”

Some other research, she added, suggests that memory performance typically “bounces back” after menopause.

While brain fog may not be pathological, some women might want relief from it.

Don’t turn to hormone replacement, Dumas advised. “There’s no good evidence that it benefits the brain,” she said.

Instead, she recommended regular physical activity.

It’s not clear whether exercise specifically clears the fog of menopause, Dumas noted. But, she said, studies of older adults have found that regular exercise can have positive effects on brain activity and mental abilities.

How to Handle Menopause Brain Fog

Maybe you’ve found yourself in the middle aisle of the grocery store, wondering what item you wanted to pick up. Or, you’ve forgotten the story that your best friend just told you over lunch, and she has to jog your memory. If you’re currently experiencing menopause, you may be dealing with brain fog, a common symptom that can occur during the many hormonal and physical changes of menopause. Read on to find out more about why menopause brain fog happens and how to manage your symptoms.

Why Menopause Brain Fog?

When you enter perimenopause, your body goes through a lot of changes that can easily affect your memory. “We think changes are related to changing hormones during this time—mostly loss of estrogen,” says Miriam Weber, Ph.D., assistant professor in the Department of Neurology at the University of Rochester. “But, they may also be related to sleep disturbance, increases in depression and anxiety, and hot flashes.”

In a study led by Weber and published in the journal Menopause, women experiencing menopause brain fog were also more likely to report symptoms of depression, anxiety, and trouble sleeping.

A good fitness program can help put your body and mind at ease. Check out the workouts from Aaptiv today.

How to Identify Menopause Brain Fog

Menopause brain fog usually crops up as trouble with attention, working memory, executive function, and/or verbal memory. What’s worrisome is that some women have been misdiagnosed with dementia or Alzheimer’s when really their memory problems were caused by menopause itself. So, how would you know the difference?

“These declines are subtle. Women don’t become impaired, but may find that they have to ‘work harder’ to function at their typical level,” explains Weber. “Some examples of what women might notice is that they have more difficulty multitasking, have word-finding difficulties, feel more ‘forgetful,’ or have difficulty concentrating.”

You might find yourself needing to make more lists or write down appointments on a calendar that you might previously have remembered without any trouble. But, know that the problems are usually going to be with your short-term memory, not the long-term one. “Remote memories—recalling childhood, significant life events, things from five years ago, and so one—are not typically affected,” says Weber.

Symptoms can begin in early midlife—ages 45 to 55—but it’s really less about age and more about the woman’s reproductive stage, according to a report published in the Journal of Neuroscience.

Ways to Combat Menopause Brain Fog

You’re not doomed to be “out of it” for the next decade or so. There are some things that you can do to lessen menopause brain fog and boost your memory.

1. Exercise.

A study suggests that 120 minutes of moderate intensity exercise per week can improve memory, whether it’s affected my menopause or not. Middle-aged women who are sedentary are more likely to experience symptoms of depression, anxiety, and insomnia.

2. Follow a brain-boosting diet.

The Mediterranean diet and the Mediterranean-DASH diet have been associated with better cognitive function and lower risk of cognitive impairment.

3. Keep your mind active.

Be wary of apps and video games promising to boost memory. The jury’s still out on whether or not those are actually beneficial. Instead, find ways to keep your mind active. Seek everyday activities that require your brain to make important connections. Read, play cards with friends, volunteer, take a class, or even practice a hobby like painting. Learning a new skill, such as digital photography or quilting, has been found to improve memory.

Also, you may want to ask your doctor about:

4. Try hormone therapy.

“Recent clinical trials show that hormone therapy initiated at the time of the menopausal transition—when women are skipping periods, or for a few years after their final menstrual period—neither harms nor benefits cognitive function,” says Weber. People sometimes use hormone therapy to combat other symptoms of menopause, so it may be worth a try. To decide it if might be right for you, discuss it with your doctor.

5. Soy protein supplements could help.

Isoflavone-rich soy protein may or may not be helpful. “There is data showing a modest benefit of soy isoflavone supplementation on cognitive function in postmenopausal women. However, women should consult their primary care physician or gynecologist before taking any supplement or over the counter remedy,” says Weber.

The good news is that the onset of menopause doesn’t mean that you’ll lose your short-term memory forever. “Our best data suggests that these changes are temporary, and memory rebounds sometime in postmenopause,” says Weber. “However, many cognitive functions change with age. We would not expect a woman in her 60s to have the same memory ability, or ability to multitask, as a woman in her 30s.”

As you read this article, your brain has begun a series of complicated chemical steps in order to form a memory. How long you keep this memory may well depend on whether you are a man or a woman.

Some scientists think that the reason for this difference may be estrogens. Women are disproportionately affected by Alzheimer’s disease, dementia and memory loss. In fact, almost two thirds of Americans living with Alzheimer’s are women. While researchers across the globe are still working to uncover the basic mechanisms of learning and memory, it is now known that estrogens help to regulate memory formation in both males and females. From a cultural and societal standpoint, when people think of estrogen they probably imagine pregnancy, periods and woman-fueled rage. Most people probably don’t consider memory; but maybe it’s time we all start thinking about estrogens’ role in memory a little more.

Karyn Frick, a professor of psychology at the University of Wisconsin-Milwaukee, studies the connection between estrogens and memory. She and her students are among the scientists working to uncover the basic cellular and molecular mechanisms underlying memory formation. Part of Frick’s research focuses on how estrogens enhance memory, particularly through their action in the hippocampus.

The hippocampus is a small, curved region in the brain that plays an important role in the formation of memories. But it wasn’t always known for this role. In fact, so little was known about the brain and memory that, when a young man named Henry Molaison laid down on the surgical table in 1953 in a quest to cure his epilepsy, a skilled surgeon named William Beecher Scoville removed several structures from his brain, including a large portion of his hippocampus.

Molaison, although almost entirely cured of his seizures, immediately developed severe amnesia that persisted for the rest of his life; in short, he was unable to form new memories. However, the work surrounding Molaison and his memory impairments set the stage for decades of research into how the hippocampus is able to transform a short-term memory into a long-lasting and persistent one.

But what does this have to do with estrogens? Estrogens, particularly the most potent estrogen, called estradiol, latch onto structures called estrogen receptors, kind of like a key fitting into a lock. These receptors are abundant in the brain regions that support memory formation, particularly in the hippocampus. Now, brain cells have branch-like extensions (dendrites) that are necessary to communicate with other brain cells. On these dendrites are short protrusions called spines.

These spines are where the communication between brain cells really happens.

Importantly, these spines change with learning experiences. They grow. They shrink. They change shape. And research shows that estradiol can even increase the number of spines within the hippocampus. Thanks to researchers like Frick, we are beginning to understand the basic molecular mechanisms by which this process happens and how it relates to memory loss in aging women.

Frick has been studying rodents for nearly 30 years. Believe it or not, most of what we now know about memory comes from research in mice and rats. Early in her career, she characterized both male and female lab mice in regard to their memory function, as there were shockingly little data on memory in female mice at that time. She tested young, middle-aged and old male and female mice on a number of tasks, including a water maze that forces mice to use their hippocampus. She found that all the young mice performed well on these tasks, and all of the old mice were terrible, but it was in the middle-aged group she observed a striking effect.

While the middle-aged males performed like young mice, the middle-aged females performed like the old mice in the water maze. Frick and her colleagues attributed this effect to “estropause,” which, while not identical to menopause, is similar in many respects. Estropause refers to when the rodent estrous cycle (which is kind of like a woman’s menstrual cycle) starts to become irregular and essentially falls apart in middle-aged female rodents.

“These females are going through a premature memory decline. The males got there eventually, but it happened earlier in females and it seemed to be associated with a loss of cycling,” she says. “Over the last decade, or more, we have focused on trying to figure out exactly how, on a molecular level, estradiol enhances memory.”

Frick does this by using two tests called the “object recognition” and “object placement” tasks. Essentially, mice love new things, and they can recognize when a new object has been placed in their environment, as well as if a familiar object has been moved. Frick and her students found that when they infuse estradiol into the hippocampus immediately after the mice first encounter the objects, the mice better remember the identity and location of objects later. This allows them to use these tests as tools for figuring out the molecular mechanisms that create memory enhancements.

Recently they have started looking at another brain region, the prefrontal cortex, in addition to the hippocampus. The prefrontal cortex is the front-most part of your brain that is important for planning, complex thinking, and personality. Like the hippocampus, estrogen receptors are found in great number here. Importantly, Frick and her students have shown that infusions of estradiol into the hippocampus affect the dendritic spines in the prefrontal cortex.

“Clearly these two brain regions were communicating together in some meaningful way, but we didn’t know whether those two brain regions both had to be active simultaneously in order for the infusion to enhance memory. All our interpretations of the hippocampal infusions that it was a hippocampus effect, but maybe not, maybe it’s a circuit effect,” says Frick. The idea of circuits, or the connections between two or more brain regions, has been of great interest to neuroscientists in recent years, particularly among memory researchers. Understanding how infusions of estradiol are helping memory at the level of the circuit is an important next step in the basic research that drives science forward. Even Frick says, “What I’m excited about is the concept of trying to figure out what’s going on in the circuit.”

But she also has another reason to be excited these days.

A team of Wisconsin researchers, including Frick, William Donaldson (a synthetic chemist from Marquette University) and Daniel Sem (a pharmacologist from Concordia University) are working together to create a drug that sticks to a special kind of estrogen receptor for the treatment of menopausal memory dysfunction. By designing the drug in this way, the researchers can avoid the negative consequences of estrogen replacement therapy, such as increased risk for cardiovascular diseases and breast cancer. Last summer, this group even formed a company called Estrigenix Therapeutics to facilitate the research and development of this drug.

Around that same time, as part of a four week long intensive program, they went out and talked to people, mostly menopausal women, physicians, and people from the pharmaceutical industry, and through that process they discovered that most patients and physicians aren’t really concerned about memory dysfunction or their potential increased risk of Alzheimer’s disease.

“Many of them weren’t even aware they were at an increased risk of Alzheimer’s disease. What they were most concerned with were hot flashes, depression and anxiety,” says Frick. So how can we make people, particularly women, more aware of the risk of memory loss as result of menopause?

“People don’t typically like to talk about menopause. It’s one of these things that women don’t like to admit that they’re going through,” says Frick. She goes on to explain that perhaps if women talk more about menopause and the symptoms of menopause, it can help make this period of a woman’s life more socially acceptable and something we can openly talk about. “Female gender, aside from age, is the greatest risk factor for Alzheimer’s disease, and most women don’t realize that,” says Frick.

As the basic science moves forward, not every step will be huge. First, we need to change the conversation so that women are aware of the risk their very gender poses.


Cognitive Function

Cognitive function refers to the brain’s ability to process information about the world and includes thinking, memory, recall, mental flexibility, problem solving and learning (1, 2). Without all these functions operating properly, people can display abnormalities that may be diagnosed as diseases or disorders. Some examples of cognitive impairment are Alzheimer’s disease, dementia and neuropsychiatric disorders (2). Cognitive impairment can be caused by numerous factors (i.e., genetics, aging, lifestyle, environment), but surprisingly, several studies have found that hormonal fluctuations are one of the key factors that lead to defects in cognitive function (3, 4, 5). Hormones are modulated from the beginning of life in utero, as the differentiations of gender begin in utero (6, 7). The sexual/gonadal hormones such as androgen, testosterone, estrogen and progesterone are continuously produced by gonads and are regulated throughout adolescence and adulthood (8).

Apart from sexual hormones, which are commonly associated with cognitive function, a stress hormone such as cortisol is in the class of the glucocorticoid hormone (5). However, hormonal levels may not remain well-maintained when certain triggers cross their pathways, such as aging and pregnancy. “It has also been established that gonadal hormones, including estradiol, can act at membrane receptors to activate intra-cellular signaling mechanisms which alter cellular function” (8, 9, 10). Apart from the synthesis of certain hormones (i.e., neurosteroids/gonadal hormones) in the brain areas, estradiol may increase the chance of altering cognition, emotions (11) and other neural factors (12). This review article discusses the literature on the hormonal relationship to neural mechanisms in cognitive function, along with related findings in neuroscience research.

Cognitive function deficit is identified through a neuropsychological assessment that comprises language, attention, conceptual reasoning, memory and processing speed (13, 14). The sex steroidal hormones mechanism begins once these hormones bind to the target tissue and translocate the hormone-receptor complex into the nucleus. Then, the complex structure interacts with chromatin inside the nucleus and changes the DNA (deoxyribonucleic acid) structure of chromatin (15) for the gene transcription process. The steroid hormones interact with the chromatin, causing an increase in ribonucleic acid (RNA) synthesis, which allows the synthesis of protein (15).

Estrogen and progesterone regulate physiology and reproductive behaviour. These hormones are believed to be responsible for activating the estrogen receptor (ER), which leads to the expression of genes, including the progesterone gene (10, 16). Estrogen induces the progesterone receptor (PR), functioning as a transcriptional mediator and regulating the transcription of target genes (17). The time taken to activate and terminate reproductive behaviour is comparable to the time estrogen takes to increase and decrease PR in the hypothalamus. However, the progesterone and estrogen pathway mechanisms are not well-defined in many aspects, particularly these hormones’ reactions towards tissue (18). Progesterone is the main hormone regulated at three different stages: the maintenance of the uterus; the development of oocytes (the mammary gland for milk production); and sexually responsive behaviour in the brain (18, 19, 20).

Estrogen has been investigated as a hormone with the potential ability to act as a neuro-protector, which may selectively benefit certain cognitive tasks such as memory-forming mediated by the hippocampus and frontal lobe (21). Estrogen hormone therapy is being selectively suggested for menopausal women who are experiencing a decline in cognitive function, for this type of therapy is believed to reduce the risk of getting dementia (22) and Alzheimer’s disease. Neuroimaging findings lend support to hormone therapy’s ability to act as a neuroprotector for menopausal women (21), which can prevent the aging-related risk of brain atrophy, specifically in the frontal lobe and hippocampal cognitive area (21, 23). Another benefit of the maternal hormones (estrogen and progesterone) is their ability to stimulate neuron outgrowth, synaptogenesis and dendritic branching in neuroplasticity (24).

Marss et al. (25) claim that maternal hormones for pregnant women have an impact on the latter’s prefrontal and hippocampal function tasks, such as attention, working memory and executive functions. Marss et al.’s (25) study is one of the most comprehensive and most recent studies that has investigated the relationship between hormones and cognitive function. Marss et al. (25) investigated the levels of six different maternal hormones present in saliva samples: progesterone, dehydroepiandrosterone sulfate (DHEAS), testosterone, estrone, estradiol and estriol. These hormone levels were then correlated with a range of cognitive tests that assessed verbal memory, speed processing and attention (i.e., the California Verbal Learning test II (CVLT-II), the Paced Auditory Serial Attention Test (PASAT), the Rey Complex Figure Test (CFT), the Finger Tapping Test (FTT), the Purdue Pegboard, the Verbal Fluency Test, the CFT-recall and the Design Fluency Test). The correlation tests of these variables revealed positive correlations between overly high/overly low hormones with reduced verbal memory, attention and processing skills during pregnancy, except for DHEAS, where no correlation was found (25). Women in late pregnancy may also experience cognitive difficulties due to significantly high hormone levels (26). However, the state of deficit in cognitive function during pregnancy does not have a high impact on daily life, with most studies finding that pregnant women tend to have normal or mild cognitive impairment (27, 28, 29). In contrast, a study by Christensen et al. (30) found a different result; in comparing the cognitive and executive functions between a group of pregnant women and a group of women in early motherhood, Christensen et al. found no positive findings to associate pregnancy and motherhood with a persistent decline in cognitive function (30). However, their study may have been limited due to the restrictions of the tests that were conducted with the neuropsychology test alone (i.e., cognitive speed, working memory, immediate recall memory), such as the Symbol-Digit Modalities Test (SDMT), the Wechsler Memory Scale and the California Verbal Learning Test, all of which do not consist of an objective test, such as the Electroencephalography (EEG), the Event Related Potential (ERP) or the functional Magnetic Resonance Imaging (fMRI). Furthermore, Christensen et al. acknowledge that the subjects’ variations due to their different backgrounds may have affected the research findings. Due to these limitations, extended research is needed to clarify these findings (30).

Nevertheless, the use of fMRI in several studies has indicated that some changes are observed in brain reactivity across the menstrual cycle, and these changes are mostly prominent in increased amygdala reactivity in the luteal phase (31). The amygdala functions as the governor of the independent memory system, together with the hippocampal complex, which interacts when motion meets memory (32). Impaired cognitive function during the menstrual cycle has been reported by Bayer et al. (33), where there was an impairment in the cognition of negatively valence stimuli in the mid luteal menstrual phase, with “no differences in behavior which have been reported in the longitudinal fMRI studies evaluating menstrual cycle effects” (33). Parallel findings on the change of lateralisation in functional cerebral asymmetries (FCAs) during women’s menstrual cycle indicate the inhibition of the dominant to non-dominant hemisphere, and this could be influenced by hormonal changes during menstruation (34). This finding has been contradicted by a recent study by (35), who found that the menstrual cycle does not cause cognitive abilities to deteriorate. However, the results observed during the first cycle in this study were not replicated in the second cycle, which may suggest the probability of false-positive attributes by random variation and systematic biases (35).

Some studies have found little connection between hormones and cognitive function. For instance, Koyama et al. (36) conducted a prospective cohort study, following up 3,044 women over a span of 23 years. The study consisted of three different phases of data collection: the blood plasma collection phase; neurologic testing; and inquired cognition of the later age phase. There were seven plasma hormones plasma tested: estrone, estrone sulfate, estradiol, androstenedione, testosterone, dehydroepiandrosterone (DHEA) and DHEAS. Tests used in the second phase of neurologic testing were the Telephone Interview of Cognitive Status (TICS) (verbal memory recalled); a telephone version of the Mini Mental State Examination (MMSE); the East Boston Memory Test (which assesses immediate and delayed recalls); the category fluency test (for measuring semantic memory); and the Backward Digit Span (working memory and processing speed) (36). This study revealed a non-significant relation between plasma levels of most maternal hormones and neuropsychology test performances, with the exception of plasma estrone, which showed a small positive association between higher plasma estrone and better cognitive performance, supporting the role of the neuro-protective agent of estrogen (36). Other than that, sex steroidal hormones (i.e., estradiol, estrone, parity, testosterone, androgens, estrogens and progesterone) are believed capable of inducing neurogenesis in the hippocampus for both males and females, as sex steroidal hormones have diverse targets in the central nervous system (CNS) (12). The hippocampus works with other regions of the brain and does not function as a single structure; it is functionally dissociated along the dorso-ventral axis (12, 37). Dispersed maternal hormone receptors are localised in the hippocampus, hypothalamus and amygdala area, and these receptors’ reactions can be mediated by neurogenesis and neuroplasticity in the brain (24) through multiple intracellular signalling pathways, including MAPK/ERK and the Akt pathway, which are involved in the cell survival process (24, 38). In addition, it is believed that impairment in this stage of the process is one of the factors in depression, mood swings, impaired working memory and executive controls (24, 39).

In the case of over-secretion of stress hormones, the class of glucocorticoids have been identified as cofactors that cause impairment of memory, but in certain ways, they can enhance memory performance (5). In the course of surviving enormous daily life changes, people are prone to many types of stress inducers, and in order to cope with stress, several neural processes become activated to develop mental and emotional coping strategies. The prefrontal cortex is responsible for making decisions about staying calm and thinking of solutions, while the amygdala generates emotional responses (i.e., anxiety, anger, happiness and fear). These structures are linked to the hippocampus in order to retrieve the relevant emotional memory so that a proper action or response can be generated (40, 41). High levels (40) and low levels (42) of glucocorticoids can impair the ability of memory due to altering the brain circuit responsible for consolidation of memory and memory storage. Conversely, moderate levels of glucocorticoid (42) and epinephrine (43, 44, 45) may enhance memory consolidation in the hippocampus. The hippocampus is highly sensitive to changing levels of glucocorticoids, and fluctuating levels of this hormone are highly associated with hippocampal atrophy (46), Alzheimer’s disease (47) and major depressive disorders (40, 48). In short, intense stress levels do appear to have a negative impact on memory ability.

Hormonal disturbance of cognitive function and emotions is commonly associated with women, as they have monthly hormonal regulation during the menstrual cycle and during pregnancy. However, hormonal disturbances can also affect men (11). Studies regarding hormones’ impact on male cognitive function is limited, as many previous studies focused on maternal hormones. In line with this scarcity of studies, there are not enough supportive findings to confidently claim hormonal influences on different cognitive functions (i.e., verbal fluency, perceptual speed and memory) among males and females (49, 50). However, a recent study by Mahmoud et al. (12) has suggested that the hormonal influence on cognitive function between genders might be relevant due to the different abilities of sex hormones to induce neurogenesis in the hippocampus (12). Berenbaum et al. (49) claim that sexual differentiation related to hormones takes place during the early prenatal and early postnatal phases, in which the high level of androgen induces the development of spatial ability and learning abilities (49). A low level of testosterone across ages can reduce cognitive function (51, 52). A review of scientific evidence about the differences of hormonal effects towards different genders was undertaken by Torres et al. (50), who concluded that female subjects perform better in verbal fluency, perceptual speed tasks, fine motor skills, verbal memory and verbal learning (50, 53). Males, however, are better in visuospatial ability, mathematical problem solving and visual memory (50). A recent review article by Ngun et al. (54) mentioned that gonadal hormones might be influenced by genetic factors, whereby the encoded genes in sex chromosomes act directly on the brain to influence neural development, and neural spatial explain the different sexual behaviour between different genders (54). However, these findings cannot be conclusive in determining the effect of hormonal differences, due to limited information about the types or level of hormones that are being studied among male and female subjects. Nevertheless, these scientific reviews by Torres et al. (50) and Ngun et al. (54) provide an insight into the view that hormonal effects may be manifested differently between males and females.

Could boosting your memory someday be as simple as popping a pill? Scientists found that rats injected with a hormone could remember better, even two weeks after the memory was formed.

The memory-boosting hormone was IGF2, which plays an important role in brain development. The researchers suggest that a better understanding of how this chemical works (IGF2 is short for insulin-like growth factor 2) might lead to drugs that enhance human brain power, particularly in individuals with Alzheimer’s and other neurodegenerative diseases.

“Understanding memory mechanisms — by that, I mean how memories are formed — we can get important information for potentially thinking about mechanisms and targets of memory impairment,” said lead researcher Cristina Alberini, of the Mount Sinai School of Medicine in New York. The next step, she said, is to look at this hormone “in memory disease models, like Alzheimer’s, stroke and aging.”

The team thinks the IGF2 gave the rats a memory charge by altering the memory-creation process in the hippocampus, a part of the brain dedicated to creating memories of places, people and things. Within two weeks the hippocampus turns short-term memories into long-term memories, for rodents and humans alike. When IGF2 was injected into the hippocampus within that time period, the rats remembered better.

Rat recall

By administering small shocks to their feet, Alberini and her colleagues trained rats to avoid a darkened area of a box. Once the rats were taught, the researchers studied how much IGF2 the rats’ brains produced, and when.

They saw that hormone levels spiked one to two days after training, and if they turned off the IGF2 (through genetic engineering) they could stop the learning process. The IGF2-deficient rats forgot to avoid the dark area.

If the scientists injected the rats with IGF2 when the rodents were first learning or while they were remembering the learning, the rats remembered better, meaning they didn’t often stray into the dark area.

“If we add into the hippocampus, we boost the memory formation significantly,” Alberini said. “We also see less decay of the memory over time; we prevent the forgetting.”

Why we forget

Most of the brain hormones that have been identified seem to do the opposite: They block memory formation.

“Enhancement is rare. Most of the time when you manipulate memory, you cause deficits; it’s easier to damage things than improve them,” said Alcino Silva, a memory researcher at UCLA who was not involved in the study. “It’s really amazing; I think we are on the verge of having the essential building blocks of how memories are made in the hippocampus.”

The team is now looking at neurodegenerative diseases to see if they can find defects in the IGF2 pathway that might have an impact on memory.

“It is possible that in some of these memory losses there is a lack of IGF2 or a lack of the receptor,” Alberini said. “Going in and looking at these markers, we can ask, ‘Is it because it is missing?'”

While having a better memory might seem like a great idea (especially to students cramming for a test!), Silva points out that forgetting is also an important part of how our brains work. “Our brains are self-adjusting, rule-making machines,” Silva told LiveScience. “We extract and extrapolate, we derive rules from various situations.” If we remember too much, he notes, we risk messing with the brain’s delicate balance between remembering, forgetting and filtering of our life experiences.

The study will be published tomorrow (Jan. 27) in the journal Nature.

You can follow LiveScience Staff Writer Jennifer Welsh on Twitter @microbelover.

What Causes Menopause Brain Fog and How’s It Treated?

You may not be able to prevent the “brain fog” associated with menopause. Still, there are some lifestyle changes you can make that may ease your symptoms and improve your memory overall.

Eat a well-balanced diet

A diet that’s high in low-density lipoprotein (LDL) cholesterol and fat may be bad for both your heart and your brain. Instead, try filling up on whole foods and healthy fats.

The Mediterranean diet, for example, may help with brain health because it’s rich in omega-3 fatty acids and other unsaturated fats.

Good food choices include:

  • fresh fruits and vegetables
  • whole grains
  • fish
  • beans and nuts
  • olive oil

Get enough rest

Your sleep quality may make your “brain fog” worse. With sleep problems high on the list of symptoms associated with menopause, getting in enough rest can be a tall order. In fact, some 61 percent of postmenopausal women report insomnia issues.

What you can do:

  • Avoid eating large meals before bedtime. And steer clear of spicy or acidic foods. They may cause hot flashes.
  • Skip stimulants like caffeine and nicotine before bed. Alcohol may also disrupt your sleep.
  • Dress for success. Don’t wear heavy clothing or pile on lots of blankets in bed. Turning down the thermostat or using a fan may help keep you cool.
  • Work on relaxation. Stress can make snoozing even more difficult. Try deep breathing, yoga, or massage.

Exercise your body

Getting regular physical activity is recommended for all people, including women going through menopause. Researchers believe that exercise may even help with symptoms like memory issues.

What you can do:

  • Try getting 30 minutes of cardiovascular exercise at least five days a week for a total of 150 minutes. Activities to try include walking, jogging, cycling, and water aerobics.
  • Incorporate strength training into your routine as well. Try lifting free weights or using weight machines at your gym at least twice a week. You should aim to do eight exercises with 8 to 12 repetitions.

Exercise your mind

Your brain needs regular workouts as you age. Try doing crossword puzzles or starting a new hobby, like playing the piano. Getting out socially may help as well. Even keeping a list of the things you need to do in the day may help you organize your mind when you’re feeling foggy.

Does your brain sometimes feel a little foggy?

Catherine O’Keeffe.

A huge number of women suffer from a variety of psychological symptoms during perimenopause and menopause including anxiety, panic attacks, brain fog and feelings of invisibility. In this blog Catherine O’Keeffe, Wellness, looks at brain fog and gives us her top tips to achieve optimal brain function. Some of us need to support our brain function as hormones readjust at menopause.

Brain Fog

In Traditional Chinese Medicine, menopause and the accompanying age is revered by society – a woman is seen as at her pinnacle of wisdom and a source of vital support for her community. In the West the story is different, at perimenopause the typical women is running after kids, ageing parents, doing a job, dashing to get food for dinner. In that dash the supermarket run – your mental list comprises three items, but by the time you get there they are totally gone from your head – inspiration doesn’t come as soon as you enter the supermarket either! Your phone rings, it’s a work call (you forgot your 1pm meeting), texts are coming in on evening activities for the kids. All the while you’re still trying to remember the 3 items – you get 2 but one remains elusive. You rush back to work.

Seriously it’s multi-tasking at the extreme – our poor brains. Women carry very heavy mental loads and when this is constant our brains need support. Your brain is changing as you age – in another world we would have ‘staff’ to help with all this ‘stuff’. In menopause we should be promoted to Chief of Staff – managerial levelJ

Brain fog is one of the heavy hitters in perimenopause. You go to the press, you haven’t a clue what you were looking for, you’re talking to someone familiar and completely forget their name. It’s so common and it is unfortunately all part of the process – as we get older our circulation slows down so less oxygen is being circulated around the body and the brain. Also as oestrogen stimulates the neurotransmitters in the brain, the changing hormone levels that come at midlife slow down these neurotransmitters and so our brains aren’t working at optimum. End result our brain isn’t as sharp as it was in our 20’s. So many women report fears of dementia, fear of losing their mind and it certainly feels like that – the good news is there are many ways to improve our brain function and eliminate the brain fog/cloudiness.

There is a whole new area of research emerging called Neuro Nutrition which reinforces the importance of taking care of our brain health and this approach looks at the body as a whole and not just the brain. The gut-brain connection has been around for a number of years now and this certainly reinforces the impact that our daily nutrition has on our brains – at all life stages.

With healthy lifestyle choices, reduced stress and nutritional support we can help our brains both heal and regenerate.

My Second Spring E-book

The Best Friend’s Guide: Anxiety – A Practical Toolkit For Moving Beyond Anxiety at Menopause – €12

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Top Tips to achieve optimal brain function

Neuro Nutrition

Omega 3 Fatty Acids, the elite brain food. The Mediterranean diet consists of foods rich in Omega 3 and offers great support in perimenopause and menopause to maintain optimal brain function. Omega 3 is the only fat that consistently goes into the brain.
 Sources: Chia seeds, flaxseeds, extra virgin olive oil, sardines, anchovies, mackerel.

Dark Green Leafy Vegetables, contain phytonutrients which are strong anti-oxidants. As such they also enhance gut health and help in the ageing process. 
Sources: Broccoli, Kale, mixed greens

Eat the rainbow – Fruit, Vegetable & Grains are another powerful source of anti-oxidants, the rule of thumb is the brighter the colour, the better, they are a rich powerhouse of antioxidants and anti-ageing chemicals.
 Sources: Blackberries (higher in Vitamin C than blueberries), apples, sweet potatoes, parsnips, brown rice, buckwheat. Recent research indicated the gooseberry or known in Indian as Amla as being the highest anti-oxidant known.

Prebiotics/Probiotics, as a second brain the gut communicates regularly with our brain, affecting our moods and energy levels. Recent research indicates 70% of our body’s serotonin (the feel good hormone) is made in the gut. Probiotics provide significant antioxidant protection and lessen the risk of developing a number of inflammation-based conditions that can affect the brain. Prebiotics are the food the probiotics will thrive and grow on.
 Sources: Probiotics: milk kefir, fermented foods. Prebiotics: garlic, white onions, apple cider vinegar

Water, dehydration is no friend to the brain or to perimenopause. It has a huge impact on anxiety and brain fog. Water is essential for optimal brain function, it prevents dehydration and increase the blood’s circulation – both of which keep away cognitive decline and nerve damage.

Ensure a minimum of 8 glasses of water a day and ideally this should be good mineral/spring water via a filtration system. The minerals in water are as essential as the water itself – this is why coconut water has such powers as a rehydration water due to the minerals / electrolytes.

Avoid alcohol, too much alcohol has a definitive impact on our brain functioning and if you do experience ‘foggy brain’ then I would certainly suggest staying away from it, as even one glass a day will impact you if you are already experiencing symptoms of brain fog.


B Vitamins are really important for the brain with the emphasis on Vitamin B6, Vitamin B12, Folic Acid and Choline. If you don’t get enough Omega 3 in your diet it is worth looking at a good supplement as this is one of the most important nutrients in perimenopause.


Exercise has been promoted as a possible preventer of neuro generative disease – this includes both physical and brain exercises. Aerobic exercise has been linked to significant increase in brain volume and cognitive function in midlife. It is also believed that exercise has an anti-inflammatory effect that promotes brain health.

The ideal is 5 times per week in 30 minute intervals where you get to the stage of feeling breathlessness, this gives oxygen to the body and also release the feel good hormones.

Exercise for the brain can be any of the following, learning a new language, knitting, puzzles, using your non dominant hand to colour or write for a few minutes each day, read a book outside of your normal reading list. You can also check out some Apps – I’m currently using Peak-Brain Training but there are loads out there to choose from.


Look at the daily stressors in your life and look at ways you can eliminate or reduce them, the less stress in your life the greater your ability to really focus and pay attention. Also consider some form of daily relaxation like mindfulness or meditation that gives your brain a complete rest and respite from the busyness of life.


None of us functions at our optimum when we have missed a few hours of good deep sleep. Our brain needs this down time to process the day’s events and renew itself. It’s a time for rest. When you have had a night of hot flushes or night sweats, you will automatically feel more tired the following day, as your body is tired so too is your brain.

Review your sleep hygiene and consider making small tweaks to ensure you are getting your required amount of sleep per night – for some people its 6 hours for others 8.

    Catherine O’Keeffe, Wellness is a midlife coach

Thanks Girls another great book ! Well done My Second Spring, the advice is practical, down to earth and I’m already working on my toolkit. Thank you so much

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About Catherine O’Keeffe, Wellness

My name is Catherine, I have a lifelong interest in health and became interested in all things perimenopause about 4 years ago. I understand the rollercoaster ride of perimenopause as I’m currently on that journey myself and so I’m graduating from the school of hard knocks…and it is a challenge! I’m constantly researching ways to ensure optimum energy, vitality and emotional wellbeing whilst in this life transition. As a health & wellness coach, I help women overcome their challenges and I share my knowledge and what is working for me and for others. I will empower you to find the strategies that work for you to achieve optimum wellbeing – as every woman’s journey is different. It is becoming more widely understood that perimenopause and menopause do not adhere to a specific list of symptoms: women’s experiences vary widely and so do the solutions to help manage difficult symptoms, every woman’s experience is unique.

Over the years I have absorbed books, articles and websites about menopause and health, in addition to the earlier years of study I did on Nutrition, Anatomy & Disease as a homeopath I am still continuing my studies in the field of menopause and have discovered many natural solutions that are providing relief to women both in perimenopause and menopause.

My Mission: To empower women at perimenopause to make the right choices to make this life transition an enjoyable and empowering one and to come out the other side feeling strong and confident.

I’m author of The Best friends Guide to Anxiety which strives to offer advice to women suffering from anxiety at this point in their journey or at any stage in life, it offers practical everyday tools to address all forms of anxiety from panic attacks to everyday anxious moments.

‘Calm the chaos, find the strategies that empower you through this life transition.’

Menopause is a Warrior’s Journey of rediscovering your true powers, it is a journey of empowerment to re discover your true voice and achieve a deep sense of wellness.

The aim of my consultations and program is to bring a whole health approach to wellness and my goal is to empower women to experience vitality through good food, healthy lifestyle, exercise and nourishing self-care – the woman’s whole life situation and emotions are also considered in a treatment plan. In the West our views of menopause are not always positive and I love the fact in traditional Chinese medicine the view is so warming and powerful. Monthly periods are called heavenly waters and when the flow of Heavenly Waters ends that part of life is referred to as Second Spring and this chapter in a woman’s life is viewed as a renewal of energy, vitality and new purpose/opportunities. Menopause is an emotional, mental and spiritual transition in addition to the experience of physical changes. My goal is to help women thrive in this journey and ease the menopause symptoms that slowly start to appear in our 40’s.


Catherine O’Keeffe, health geek, homeopath, food lover, ex director financial services. Mum to three young boys. My degree in 1992 from Trinity College Dublin was in Business Studies. I worked in financial services in London, New York, India and Dublin over a period of 24 years. In 2005, I completed 4 years training to become a homeopath. During the past 3 years I have been a volunteer with Scouting Ireland. I have an understanding of the challenges women deal with on a daily basis when in perimenopause and with a young family. With women becoming mothers later in life the trend is that we are experiencing menopause whilst dealing with the challenges of a young family. I enjoy the benefits of exercise, good food and healthy lifestyle habits to lead a full life. For me, perimenopause is an inevitable journey for women and the more preparation and self-education we can do will ease this life transition and make it a more positive time in your life.

I have a whole health approach to wellness and my goal is to empower women to experience vitality through good food, healthy lifestyle, exercise and nourishing self-care – the woman’s whole life situation and emotions are also considered in a treatment plan.

I will help empower you to find the strategies that work for you to achieve optimum wellbeing – as every woman’s journey is different. It is becoming more widely understood that perimenopause and menopause do not adhere to a specific list of symptoms: women’s experiences vary widely and so do the solutions to help manage difficult symptoms, every woman’s experience is unique.


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  • Can Menopause Cause Brain Fog?

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    It’s not uncommon for women going through menopause to complain about their memory. Are those bouts of forgetfulness real or imagined? Or something else entirely, like some sort of dementia?

    It’s real, isn’t it?

    Exactly. It’s not just in your head. Menopause and brain fog are linked. If you need more than your own personal bouts with brain fog or fuzzy thinking for evidence, take a look at this: One 2012 study in the journal Menopause found that when premenopausal women were given a battery of cognitive tests, the ones who identified themselves as having memory problems were the same ones who had trouble completing challenging tasks. That’s right. These same group of women also scored low on tests of working memory. And lest we forget to tell you, they also had a hard time processing new information.

    Other research has supported the link, too.

    And the culprit is …?

    Estrogen, naturally. It’s not only hot flashes and night sweats that happen when this hormone plummets. There are significant brain changes, too. This is evident in many ways. Just try asking your (menopausal) friends how many times they’ve lost their keys, had trouble organizing tasks or forgot things like a word, an appointment or their good friend’s name this week.

    And MRIs show it, too. When 200 men and women between the ages of 45 and 55 were given standard memory tests, the functional MRI scans that tracked their brain activity found that women with lower levels of estradiol (a form of estrogen produced by the ovaries) did worse on those tests and had more pronounced changes in their brain activity.

    Got it. But what about things that menopause brings, like depression, sleep issues, hot flashes and night sweats, which all make my brain hurt?

    While they all can definitely cause memory problems, they’re not the primary cause of cognitive issues in women. It’s estrogen, quite clearly, as shown in this study published in the American Journal of Epidemiology.

    Does this brain fog affect a lot of women?

    Affirmative. Up to 60 percent go through what’s known as “menopause-related cognitive impairment,” according to some studies. So, that means if two friends going through menopause talk to each other, there’s a good chance one out of the two will forget some details of that conversation. Think of it this way: There will always be something new (?) to talk about!

    But then again, there are women who find no changes at all in the way their brains function around menopause. Though researchers don’t know exactly what differentiates them from the others, they think it might be that their brains are resistant to the waning levels of estradiol. Or maybe their brains are able to draw estrogen from sources other than their ovaries (like maybe from body fat or by converting testosterone). Or it could also be that these women are protected by doing physical or mental exercises.

    So will this be my new normal? A semi-functioning brain?

    Fortunately not. It’s found that after menopause, the body “rights” itself and, like a loyal dog gone missing, brain function returns after a while. Let’s just say that this too shall pass.

    That sounds promising. What can I do while I wait it out?

    Fortunately, there are things you can do to boost your mental health—things that are shown to help anyone, even if they’re not passing through menopause.

    For some, short-term hormone replacement therapy can help. Nonhormonal treatments used for hot flashes (like the antidepressant paroxetine, or Paxil, and the anticonvulsant and pain reliever gabapentin) have also been found to be helpful in relieving cognitive symptoms for some.

    Healthy lifestyle changes like adopting a Mediterranean diet (rich in fruits, veggies, whole grains, legumes, nuts and healthy fats), exercising and minimizing alcohol consumption can all be brain-protective and boost brain health and your mood. (Because, face it, memory problems can cause anxiety and mood problems, too.)

    Anything else I should know about brain fog and menopause?

    Since it might take longer than it usually does to do certain things like remember someone’s name or cement a new piece of information into your memory, it could be helpful to repeat it out loud or repeat it back to the person who has said it to you. That’s one way to help you hold onto that information longer, say experts.

    And don’t underestimate the power of things like crossword puzzles, learning a foreign language or reading. The goal is to find things you enjoy and challenge your brain at the same time. A win-win—and a way to manage your menopause that much better.

    Give this a thought, too.

    Though it’s annoying and disheartening to find your once-sharp brain not functioning on all cylinders, the good news, according to studies, is that these changes are temporary and there’s no link to diseases like Alzheimer’s or other forms of dementia.

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