I used to joke (with a big dollop of worry mixed in) that I had early onset Alzheimer’s. I apologize to anyone who has a loved one that has suffered from this disease because I know it is no laughing matter. But I did actually worry that maybe that’s what was happening to me. I didn’t realize it was perimenopause brain fog.
I’d walk into a room with great purpose, only to get there and have no idea why I was there. “Ah, my early onset Alzheimer’s.”
Someone would ask me what I had for dinner the night before and I would struggle for several moments, trying desperately to remember an event that happened just 12 hours before. “Sorry, it’s my early onset Alzheimer’s.”
In a meeting I would lose my train of thought mid-sentence, or completely forget a really basic word and struggle to recover. “Don’t mind me… I’ve got early onset Alzheimer’s.”
A Post It Note and Sharpie were always within arms reach and my house was (and still is, if I’m being honest) littered with reminders. They were everywhere. I mean everywhere. “You know me. My memory is a sieve. I have early onset Alzheimer’s.”
Could this be Dementia or Alzheimer’s?
The truth was that as much as I joked about it, there was always an element of fear mixed in. My grandmother had suffered from dementia for the last 4 years of her life, and I witnessed firsthand how challenging and heartbreaking this was. There were days when she would have moments of clarity and break into tears because she realized that she had no idea what she’d been doing for the past several days. Times (before she was put in long-term care) when the fog lifted and she would find herself out walking on the road, kilometers from home with no idea of how she got there or how to get home. These were terrifying and difficult times for the whole family.
So when I was just 42 and started to recognize some of these memory issues in myself, I naturally became concerned. Could I actually be in the early stages of dementia or Alzheimer’s disease? I didn’t know much about it, but I’d heard there was a genetic component to the disease. Life was busy though (young child, work, family commitments) and so instead of letting myself go down the rabbit hole of worry, I chose to use humour as my armor.
I struggled silently with this fear for several years. And then one day, while listening to a podcast, I learned that brain fog was a symptom of perimenopause. Wait. What?
How come I hadn’t heard this before? I had been convinced for years that I was in perimenopause, and yet I hadn’t come across this brain fog nugget yet. Could this be the reason I struggled almost every day to remember where I’d left my phone, or if I’d turned off the stove, or what time I was supposed to get to my meeting? To say this was a relief is the understatement of the year.
What is Brain Fog?
Once I knew this information, I started to talk with friends about it. Like the other times I’d opened up about the strange and unusual perimenopause symptoms I was experiencing, my confession opened the door to conversations and realizations that I was not the only one suffering from these cognitive symptoms in silence.
So many other friends were also suffering from feelings of confusion, forgetfulness, difficulty concentrating or focusing and just generally having a hard time staying on task. For some, their menopause brain fog was accompanied by low energy levels and mood swings. And new emerging research shows that in fact, brain fog affects around two-thirds of menopausal and perimenopausal women.
So why are so many of us suffering with cognitive symptoms during perimenopause and menopause? You’ve probably guessed it already… hormonal changes and imbalances. What else is new, right?
How Estrogen and Progesterone Affect Our Brains
During this midlife change, the levels of estrogen and progesterone go up and down a lot, said Louann Brizendine, professor of psychiatry at the University of California at San Francisco.
Progesterone is the first hormone that usually drops. When it does, it can make a person feel irritable, have mood swings, and have trouble thinking clearly. And we all know that not being able to sleep well can also happen when progesterone drops and that only makes it harder for our brain and memory to work.
Brizendine goes on to say that “When estrogen is high, the brain and other tissues get an ‘estrogen shower,’ which is responsible for breast tenderness and memory issues.” And then, as our estrogen levels go down (because of our monthly cycle or the perimenopausal hormone roller coaster) many women will get hot flashes, mood swings, irritability, mental confusion and decreased energy. These things can all further contribute to hormone-related brain fog.
Other studies are finding that there might be a relationship between losing the ability to remember words and how bad hot flashes are. One study showed that the women who had the most hot flashes in a day also had the worst scores when they were tested on their memory for words. But even if a woman is not experiencing any other menopausal transition symptoms, her memory can still be affected by the drop in hormone levels.
What Are The Main Symptoms of Perimenopausal Brain Fog?
As I talked with girlfriends about this strange new phenomena, we began to compile a list of the symptoms we felt were related to our brain fog. I’m sure there are others, but here’s what we came up with:
– Feeling overwhelmed and disorganized – more so than usual;
– Forgetfulness and difficulty focusing – did we all just develop ADHD?;
– Trouble with short-term memory recall – dinner last night? No idea;
– Difficulty finding the right words when speaking or writing – ..???
– Low energy levels and fatigue – ok so we’re not sleeping, but we know enough to know that this is likely connected;
– Mood swings – all this brain fog is really frustrating and it’s pissing us off!
What is the connection between brain fog and depression?
There is not a full understanding of the connection between brain fog and depression. But it is believed that the hormonal changes related to perimenopause can make middle-aged women more prone to anxiety and even increase the risk of depression.
It seems obvious then that our feelings of overwhelm, disorganization, and difficulty concentrating can further compound our sadness or feeling like things will never get better. Add to this the fact that we’re not sleeping and have low energy levels and you’ve got yourself the perfect storm. These symptoms are different from a bad mood, feeling sad or blue. They are much more intense, don’t go away on their own and they make it almost impossible to function at work and at home.
How Can I Treat Brain Fog?
As with most menopause symptoms, the good news is that there are steps you can take to manage your brain fog and reduce its effects.
Don’t shoot the messenger. I understand that you want nothing more than a good night’s sleep and despite all your efforts, it’s almost impossible. So just do your best to create a healthy sleep routine: avoid eating 2-3 hours before bed, turn off electronics an hour before bed (take a relaxing hot bath instead), go to bed and wake up at the same time every day, try to get at least 7 hours of sleep each night and make sure your bedroom is quiet, cool and dark. Sleep is super important for our brain health, so do your best to reduce sleep disturbances.
Again, this one’s pretty basic. Eat a healthy diet complete with fiber, protein and fat. Try to eat whole foods (think food that grew in the earth, lived on the earth, or swam in the sea) and avoid trans fats and processed food.
Although some people believe that a glass or two of red wine might actually help prevent brain cell damage (because of the ingredient in it called resveratrol) the truth is that alcohol is not a friend to perimenopausal women. It makes our hot flashes and insomnia worse and it leads to weight gain and increased blood pressure. As hard as it is, we should try to avoid alcohol as much as possible.
Here’s one you might now know… avoid diet sodas. I know they are zero calorie drinks and we’re all trying to watch the growing belly fat, but artificial sweeteners like aspartame are not good for your brain. Studies show that people who drink diet drinks are more likely to have a stroke or develop dementia than people who don’t consume them.
We’ve been told a million times how important exercise is for our bodies and overall health, but did you know that it might also help your memory? A small study published in Supportive Care in Cancer in July 2021 involving 73 post-menopausal women with breast cancer found that those who engaged in more physical activity performed better on several tests of memory and brain function than those who exercised less.
Does this mean that exercise will help stop memory loss associated with menopause? The jury is still out, but researchers are exploring the connection between the hormones produced during exercise and our brains’ abilities to repair existing cells.
Exercise your mind
Challenging your brain every day by reading, doing puzzles like sudoku or crosswords, playing an instrument or learning something new can help to keep your brain firing on all cylinders. Staying socially active and engaging with people in conversations also helps to stimulate the brain. If you find yourself struggling, get out the sharpie and Post Its; keeping a list can help reduce the frustration that comes with feeling disorganized and overwhelmed.
Easier said than done, right? Many women in the menopause transition are part of the sandwich generation. We are juggling family and home responsibilities, careers and taking care of aging parents – stress is an unwelcomed part of our lives.
But the truth is that all this stress is bad for our memories. So we really need to find ways to manage our stress and take care of ourselves. Taking time each day to get outside, taking a bath, doing some meditation, yoga or breathwork, exercising and even socializing with friends are all great ways to help us unwind, reduce anxiety and sleep problems and keep our brain health intact.
You may have heard of Ginkgo Biloba – the miraculous memory herb! Although many people believe in its powers to combat memory loss, the jury is still out and studies have yielded mixed reviews. Omega fatty acids like those found in fish, fish oil, seeds, and nuts care also touted for their abilities to protect our brain health.
If you are considering taking supplements to support your cognitive symptoms, make sure you talk with your health practitioner first. Supplements can have serious negative side effects when mixed with certain medications.
Menopause Hormone Therapy (MHT)
This one is the cause of great debate right now. MHT (also known as Hormone Replacement Therapy or HRT) is a treatment that many doctors believe can help with menopausal symptoms like hot flashes and vaginal dryness. There is new research emerging that indicates there may be a connection between levels of estrogen and women’s brain health. So while MHT is not routinely recommended for menopausal brain, it’s at least worth paying attention to and watching to see what new research continues to reveal.
As we age and our health starts to decline, many women find their doctors prescribing medications like sleeping pills or antidepressants. What your doctor might not tell you is that these drugs can affect how well your memory works, so If you notice brain fog or other cognitive symptoms, make sure to talk to your doctor or pharmacist.
I left this one for last because I shouldn’t have to tell you this… Smoking is bad for you, for so many reasons. For the female brain it not only affects the cerebral blood flow, but it also impacts other menopausal symptoms like hot flashes, increased risk of heart disease, and may cause cancers. Just say no!
Does perimenopause brain fog go away?
If you’re suffering from brain fog, you will be relieved to know that most doctors agree that brain fog associated with perimenopause will go away when women reach post-menopause and that it’s not linked to an increased risk of dementia or Alzheimer’s. When I learned this, I let out a huge sigh of relief!
Perimenopause brain fog can be a frustrating and oftentimes embarrassing side effect of the menopause transition. But if we take the steps to understand and address the underlying causes of brain fog, we can reduce the severity of these symptoms and feel more like our old selves again.