For Women, Midlife Brain Fog Is Real. Here’s Why.
Download someone's name. Forget why you entered the room. Struggle to focus on one task.
Women in their 40s and 50s often notice a decline in memory, concentration, and ability to learn new things — symptoms sometimes called "brain fog."
Doctors have good news and bad news. There's a good chance these problems are caused by normal hormonal changes in midlife during perimenopause, and they often get better after your last period. Medications, along with exercise and a healthy diet, can help. The bad news: For some women, these problems persist.
Menopause, which usually occurs when a woman is in her 40s and 50s, begins when a woman's menstrual cycle becomes irregular and can range from three years to more than a decade. The extreme fluctuations in hormones during this time lead to many symptoms, including hot flashes, night sweats and mood swings.
Studies show that approximately 60% of women report decreased memory function during perimenopause. Despite these changes, the general cognitive functioning of most women remains normal.
New guidelines commissioned by the International Menopause Society, a group of doctors and researchers that makes recommendations for menopause treatment, advise healthcare professionals to tell women they have no symptoms of dementia. The guidelines state that memory problems often resolve once a woman reaches menopause, the point at which she hasn't had a period in a year.
"The most important thing is to reassure women that these experiences are normal," says Pauline McKee, MD, professor of psychiatry, psychology, obstetrics, and gynecology at the University of Illinois at Chicago and first author of the series of guidelines published today. last year in the diary. menopause.
Researchers say men don't report similar memory and cognition changes because they don't experience this dramatic change in hormone levels. Overall, women generally have better verbal memory than men, even during perimenopause, says Dr. Mackey, while men generally have stronger visuospatial skills.
A source of concern
Tammy Willis says she first noticed she was losing her words in her 40s.
"I would forget words and words I knew," says Mrs. Willis, 51, of Decatur, Georgia. "I'd be completely blank on people's names."
She was initially concerned that she was suffering from cognitive decline, which afflicts the older women in her family. But when I started a Facebook support group for perimenopausal women, I heard from other women with similar complaints.
"I'm really hoping that by next year, when my hormones have stabilized, it will get better," says Ms. Willis.
Dr. Mackey says the women who appear to be most affected by cognitive problems during perimenopause are the ones who also experience the worst vasomotor symptoms, such as hot flashes and night sweats.
Brain scans of women with nocturnal movement symptoms have shown signs of small vessel disease in the brain associated with cognitive decline, says Rebecca Thurston, a professor at the University of Pittsburgh who was the first author of a study documenting these findings on Neurology magazine. Neurology.
For some women, brain fog may result at least in part from lack of sleep caused by night sweats and hot flashes, or mood symptoms common during perimenopause, doctors say.
In these cases, treating these symptoms can help with cognitive issues, says Stephanie Faubion, MD, director of Mayo Clinic Women's Health and medical director of the North American Menopause Society. Menopausal hormone therapy — which takes a form of estrogen often combined with progesterone — has been approved by the US Food and Drug Administration for the treatment of hot flashes.
Studies have shown, for example, that if you remove women's ovaries before natural menopause, their memory jumps back, and if you give them estrogen therapy, their memory recovers.
