Brain Fog in Perimenopause and Menopause
It’s all in your head!!
Well turns out it might just be and by that, I mean quite literally. We’ve all experienced brain-fog to some degree particularly in perimenopause and after menopause. Studies show biological brain changes in menopausal women that does not appear to happen in men of the same age, this suggest that women are more sensitive to hormonal aging as opposed to chronological aging. (Source: L Mosconi 2019)
While the physical symptoms of menopause, such as hot flashes and night sweats, are widely recognized, the neurological changes that occur during this transition are often overlooked. Research data by Physician and Neuroscientist Lisa Mosconi indicates that menopause is a dynamic neurological transition, significantly affecting brain structure, connectivity, and metabolic profile during the midlife endocrine aging process in women.
One of the most commonly reported neurological symptoms during menopause is brain fog with over 60% of women being affected to some degree. This term describes a range of cognitive difficulties, including confusion, forgetfulness, and lack of focus. Women experiencing brain fog often report feeling mentally sluggish and disorganized, struggling to concentrate or process information. Despite its prevalence, brain fog is sometimes dismissed as merely psychological. Being told that “it’s all in your head” is dismissive and can feel like being gas-lit, especially since brain fog is a valid and well-recognized symptom of menopause.
In addition to brain fog, menopause can impact the brain’s structure and connectivity. Studies have shown that hormonal changes during menopause can lead to alterations in brain regions involved in memory and cognition. These changes are linked to fluctuations in estrogen levels, which play a crucial role in brain function. Reduced estrogen levels can affect the brain’s ability to utilize glucose, its primary energy source, leading to decreased efficiency and potential cognitive decline.
Furthermore, being female is a risk factor for dementia, which affects more women than men. Although women generally live longer than men, this alone does not fully explain the higher prevalence of dementia in women. The hormonal shifts that occur during menopause may contribute to this increased risk, making it even more critical to understand and address the cognitive changes associated with menopause.
As women we may feel these brain changes, we don’t feel like our old selves, yet we are told it’s all in your head, you are making it up and NOT possible! By acknowledging the validity of symptoms like brain fog and understanding the underlying brain changes, we can better support women in managing this significant life stage.
A recent meta-analysis found positive effects of time-dependent MHT on certain aspects of cognition, with variations based on formulation and timing of initiation. Further research with larger samples and more robust study designs are needed. (C Andy et al 2024) At present MHT is only approved for night sweats and hot flashes and MHT for cognitive benefits remains controversial.
Strategies that you can implement now are:
Maintain a Healthy Nutrient-rich Diet:
- Incorporate a diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats particularly Omega 3 fatty acids. Foods high in antioxidants, such as berries and leafy greens, can help protect brain cells from damage. Salmon, mackerel, flaxseeds and walnuts support brain health by reducing inflammation and promoting cognitive function.
Regular Physical Activity:
- A mixture of aerobic exercise and strength training improve blood flow to the brain, support metabolic health Activities like walking, swimming, and cycling can improve blood flow to the brain and enhance overall brain function. Aim for at least 150 minutes of moderate-intensity exercise per week.
Practice Cognitive Brain Exercises
- Challenge your brain, such as puzzles, reading, learning a new language, or playing musical instruments. These activities can help improve memory, attention, and problem-solving skills. Mindfulness and meditation can reduce stress and improve cognitive function. Regular meditation can enhance attention, memory, and emotional regulation.
Ensure Quality Sleep:
- Aim for 7-9 hours of sleep per night. Create a calming bedtime routine, maintain a regular sleep schedule, and ensure your sleep environment is conducive to rest.
- Manage sleep disruptions by addressing common menopausal sleep disturbances, such as night sweats and insomnia, by keeping your bedroom cool, using breathable bedding, and practicing relaxation techniques before bed.
Manage Stress and Emotional Health:
- Engage in activities that help reduce stress, such as yoga, deep breathing exercises, and spending time in nature. Chronic stress can negatively impact cognitive function, so finding ways to manage it is crucial. Seek support by talking to friends, family, or a mental health professional can provide emotional support and help you navigate the challenges of menopause. Joining support groups can also be beneficial.
So, if you have been told by your doctor or other health professional that it’s all in your head, YOU need a new GP who supports you as well as understands the complexities and realities of menopause. Reach out and I can point you in the right direction. If you need help with managing your symptoms book in a FREE 20 min chat.
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Sources: https://www.ted.com/talks/lisa_mosconi_how_menopause_affects_the_brain?language=en