Menopause Brain Fog: keeping your wits about you
Let’s talk brains: We know perimenopause and menopause can impact our brains.
Women report feeling mentally “foggy,” having trouble concentrating, struggling to find the right word or remember if they scheduled that dentist appointment. Like the zombies we sometimes feel we’ve become, we just want a fresh brain.
What causes a foggy brain in menopause?
It usually starts in perimenopause, as estrogen levels begin sloping downward. Foggy brain (and some short-term memory impairment, fatigue, and loss of focus) happens because, as neuroscientist Dr. Lisa Mosconi told us, estrogen is a “master-regulator” of our brains. We have lots of widely distributed estrogen receptors in our brains, and when estrogen levels decline, a critical energy source is gone. To put it simply, perimenopause brains are tired.
Fortunately, menopause brain fog is largely temporary. In menopause, women do lose the neuro-protective effects of estrogen, but as our bodies adjust to decreased levels of hormones, so do our brains.
Is it menopause brain fog or dementia?
This question comes up a lot at Gennev – women can’t remember where they left their keys; a friend’s name suddenly pops out of their brains; they can’t retrieve the right word in conversation – and they fear they may be experiencing early-onset dementia.
While brain fog is irritating, it’s generally just that – irritating. Dementia is far more likely to disrupt life and normal activities. Have you stopped doing tasks you normally did (household finances, for example) because you feel unable to do them? That might indicate a more serious issue.
If you’re worried your memory lapses may be more serious, the Alzheimer’s Association has a list of the 10 Early Signs and Symptoms of Alzheimer’s and a number you can call to speak with an expert about your concerns.
How long does menopause brain fog last?
It’s great that menopause brain fog isn’t forever, but the fact is it usually starts in perimenopause and can hang on even into early menopause, meaning women may not feel as sharp or focused for several years. Given that women in their late 40s and early 50s are often at the height of their careers, who can wait?
So do we just resign ourselves to hiring a random teenager to program the DVR?
You can, if you want to. Or you can leverage your brain’s natural neuroplasticity, training your brain to make new connections when older ones fail. Hormones and 50th birthdays notwithstanding, you – yes, you – can program your own DVR.
Natural treatments for brain fog
Roll up your sleeves, because it’s about to get all science-y up in here. The best “natural” remedy for menopausal brain fog might be … thinking. Learning. Using your brain in new ways helps it “learn to learn” again.
Research scientists Denise Park and Gérard Bischof define neuroplasticity as “the brain’s ability to increase capacity in response to sustained experience.” Because the human brain is “plastic,” it’s flexible enough to reorganize itself and form new neural connections. Our plastic might become a bit less malleable with age, but there’s still plenty of opportunity to learn. And it gets easier.
Neuroplasticity typically comes up when the brain has suffered damage from, say, a stroke or accident. When part of the brain is damaged, the function it controls may be lost or impaired: the person may no longer be able to speak or they might lose the ability to walk. Neuroplasticity allows the brain to reroute the function to other, undamaged areas of the brain.
In fact, our brains are constantly reorganizing, like a computer defragmenting to make more space and increase efficiency. And we can take advantage of that fact, even when our brains aren’t damaged by anything more than age.
Why is brain health particularly important for women in menopause?
Hormonal brain fog is frustrating and annoying, and the impact on a woman’s self-confidence can have downstream effects on families and careers. Women are amazingly adept at dealing with the occasional inconveniences of our own reproductive systems – shall we name the ways we’ve discreetly carried a tampon into the ladies’? – but the stress of feeling foggy plus the stigma attached to talking about menopause in the workplace can take their toll over time.
Further, women are more at risk than men of developing Alzheimer’s disease and dementia: women over 65 stand a 1-in-6 chance of developing Alzheimer’s; for men, the risk is 1 in 11. It’s possible that training our brains early, well before the brain is significantly impaired, allows for a later onset of the disease. Like any muscle, the earlier we start strengthening, the more benefit we’ll see.
How do we maximize our brain’s natural neuroplasticity?
While there’s research still to be done to prove it, it does appear that making our brains work harder to learn new things and acquire new skills helps our brains stay plastic and flexible. Repeated demands allow new neural pathways to form. Here are some tips for putting your brain through its paces and supporting brain health in your everyday life.
Do hard stuff over and over again
I have a terrible sense of direction and rely on Waze and similar apps to get me from A to B, even in my own city. This, according to research, is not a good idea. Forcing myself to think through the available choices and decide the best path is a good, challenging mental exercise that can be repeated. Once I’ve mastered the Waze app, on the other hand, there’s really no more learning to do. Take up a musical instrument, if that interests you. Learning a new language is a great idea – the complexities of grammar, the rote memorization of new vocabulary help remind your brain how to retain information and force you to access that new information over and over again.
Play brain-training games
While the jury is definitely still out on how much you can gain from these games, games designed specifically for improved cognition do appear to “confer some benefit” (scientist speak for “don’t expect to turn into Einstein overnight”). The games should be fun, challenging, and allow you to graduate to harder challenges as you improve. While brain games may not make us smarter or delay onset of dementia, they may make learning new things easier, even as we age.
Do smart stuff with other smart people. You’ll enjoy it more, expand your horizons, and possibly protect your neuroplasticity in the process.
Get plenty of Omegas 3 and 6
Fish, fish oil, seeds, and nuts all appear to play a role in protecting brain function. Fluid intelligence – our problem-solving smarts – and memory preservation are supported when we have balanced, abundant reserves of Omega fatty acids from our diet. Vitamin B12 deficiencies might also cause fuzzy thinking, so be sure you’re getting plenty of this nutrient. It can be particularly difficult for vegans to get enough, so consider supplementing if you may be falling short.
Speaking of diet… Calorie restriction (cutting calories by 30%) and intermittent fasting have been shown to have some protective effects, though both should be done carefully and under the watchful eye of a medical professional.
As Fezzik says in The Princess Bride, “Everybody move!” Exercise increases our levels of BDNF (Brain Derived Neurotropic Factor), the compound that promotes the formation of new neural networks. Just how much exercise is yet to be determined, but combining exercise with Omega 3 and 6 supplements may boost the brain protection ever further.
Mindfulness meditation, positivity, reduced stress, and love, sweet love are all good for our brains (and the rest of our bodies). All reduce internal inflammation which can deteriorate neural pathways. (Find out more about mindfulness meditation here.)
Finally, sleep. Just as your muscles need rest between exertions, so does your gray matter. Chronic lack of sleep causes inflammation that can slow brain recovery and impact… well, pretty much everything: memory, metabolism, attention, function. But everything you don’t need your brain to do should be fine!
Medicine for menopausal brain fog
Menopausal foggy brain is the result of decreased estrogen, so it stands to reason the best treatment for menopause brain fog is replacing the estrogen.
HRT (hormone replacement therapy) may, in fact, help; hormonal birth control pills in perimenopause can also help by keeping estrogen levels constant. And despite what you’ve likely heard, many if not most women can take HRT safely, provided it’s prescribed correctly and you follow your OB/GYN’s recommendations. HRT is generally not prescribed for cognitive issues alone, but if you’re also experiencing hot flashes and other disruptive symptoms, it may benefit your brain too.
For those who can’t or prefer not to take hormonal treatments, the North American Menopause Society did a review of non-hormonal treatments in 2015 and found a low dose of the antidepressant Paxil or the anticonvulsant and pain reliever gabapentin may help relieve the foggy brain feeling of perimenopause and menopause.
The brain’s ability to heal and learn may slow with age, but that doesn’t mean older adults are out of luck when it comes to learning new things. In fact, the very act of engaging in learning probably makes the next effort easier.
So find something that challenges you mentally and that you enjoy and will stick with. Do that challenging thing with friends, while eating nuts and exercising vigorously, and you may find your gorgeous, malleable, plastic brain is fuller, healthier, and happier than ever.
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