Some things in life are less than fair. Not only do many women experience "Pregnancy brain" and "Mummy brain" when our ability to retain relevant information sometimes appears to go to mush, it also appears we can joyfully expect to experience "Menopause brain" when transitioning from being fertile to becoming infertile.
"Menopause brain" is nothing new, in fact 60% of women going through menopause will report memory problems, yet this has remained an area where fabulously little research has been undertaken to try and understand what is really going on with our brains at this time in our lives.
What has been reported, is that not only do many women experience significant changes with their memory, but because these changes occur typically in our late forties and early fifties, we become frightened that these changes could herald the first signs of cognitive impairment and Alzheimer's disease. That fear of course then compounds the brain's inability to think clearly and a vicious cycle can ensue.
So first things first: there are brain changes, which occur in the menopausal brain that can affect memory. These changes reflect a physiological change and are not the first signs of neurodegenerative disease i.e. Alzheimer's.
So what is going on here?
Back in 2009 a study on 2362 women aged between 42 and 52 looked at
• Verbal memory • Working memory (short term) • Speed of processing information
The women were tested at four different stages of transition through menopause i.e. pre- menopause (regular periods), early peri- menopause (some irregularity of periods), late peri-menopause (no period for 3 - 11 months) and post menopause.
As I mentioned earlier, up to 60% of women will report memory difficulties during menopause and this study confirmed that during the early and late peri menopause, women do not learn as well as when they are in the other stages.
The good news is that this effect appears to be temporary. Our ability to learn returns to pre menopausal levels once we become post menopausal.
The other interesting note here is the role of hormones (or rather HRT) on our verbal memory and processing speed.
Taking HRT before menopause appears to help verbal memory and processing speed. But taking HRT postmenopausally has no effect on these skills.
This suggests there is a critical window of opportunity for the benefit of oestrogen and progesterone supplementation here. However much depends on the individual and their relative risk factors for consideration of using HRT at all.
Another study in 2009 examined the relationship between peri menopausal memory complaints and performance in relation to other relevant factors such as hormone levels, mood state, and sleep quality. In this small study of 24 women, there was no association of memory complaint and performance on tests of retentive memory. What they did show was memory complaints were linked to poorer memory encoding (i.e. learning) and depressive symptoms.
Miriam Weber PhD a neuropsychologist at the University of Rochester Medical Centre has now published the findings of a new study in the journal Menopause. In this study 75 women aged 40 to 60 who were in early peri menopause underwent a series of cognitive tests to look at their
• Ability to learn and retain new information (encoding memory) • Ability to mentally manipulate new information (using working or short term memory) • Sustain attention over a period of time (paying attention)
They were also asked about any symptoms associated with menopause such as hot flushes, depression, and anxiety and sleep difficulty. Plus they underwent blood tests measuring oestrogen and FSH levels.
The study showed that those women who had noted memory problems were the ones who demonstrated difficulty with learning, retaining and manipulating new information.
The examples given of difficulty experienced included
"Calculating the tip after a meal at a restaurant, doing mental math, or adjusting a flight itinerary for a journey"
They were also noted to have difficulty staying on task i.e. paying attention.
Remembering specific items for example on a grocery list and recalling them when in a shop were not an issue.
The actual hormone levels were found to have no association with the memory complaints, though experiencing difficulty sleeping or anxiety and depression symptoms did.
What can we do to help?
The best thing to do if you are experiencing memory difficulty associated with the peri menopause would be to
1. Address any sleep problems. Talk to your GP. Follow good sleep hygiene practice.
2. Address anxiety or symptoms of depression. Talk to you GP about the different options you could choose to ameliorate these.
3. Find and use strategies to help you with encoding and retaining information. This could include simple tricks such as • Repeating a new price of information out loud • Saying it back to another person for confirmation • Practice attention building skills such as meditation to help stay on task for longer.
And of course relax, it's only your "Menopause brain" playing up and the good news is that by the time the post menopausal state is reached, your brain fog will have cleared and you can then enjoy the wisdom and serenity that being post menopausal will bring.
Refs: 1. Miriam T. Weber, Mark Mapstone. Memory complaints and memory performance in the menopausal transition. Menopause. 2009 Jul-Aug;16(4):694-700.
2. American Academy of Neurology (2009, May 25). Menopause Transition May Cause Trouble Learning. ScienceDaily. Retrieved March 18, 2012, from http://www.sciencedaily.com¬ /releases/2009/05/090525173427.htm
3. Miriam T. Weber, Mark Mapstone, Jennifer Staskiewicz, Pauline M. Maki. Reconciling subjective memory complaints with objective memory performance in the menopausal transition. Menopause, 2012; 1 DOI: 10.1097/gme.0b013e318241fd22