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Brain fog and memory changes

Hormones have an important role to play in the way your brain works. When your hormones are changing in perimenopause, and drop after menopause this can cause changes to memory and concentration.

Changes to memory, focus and concentration are a common symptom of menopause. These changes can appear quite suddenly, and be hard to notice. It might be that you’ve been forgetting your keys a bit lately, or putting things in strange places. Or perhaps just finding it much more difficult to concentrate at work? Here we explain why perimenopause and menopause can cause changes to how your brain works, and how you can manage these changes.

What is brain fog?

Brain fog is a descriptive term used to describe a feeling like your brain is full of cotton wool. I sometimes call it ‘cloud brain’. It makes it difficult to take in new bits of information, or to concentrate for too long. This feeling is something that many women experience in perimenopause and menopause. It can make working very difficult, but also more basic parts of life like reading challenging.

Menopause and your memory

There are many ways in which perimenopause and menopause can wreak havoc with your memory. Both the hormones oestrogen and testosterone play a role in cognition (thinking) and memory. These hormones drop as we progress through menopause, which can change the way your brain works.

It’s not only the changes in your hormones which drive changes to memory. Other symptoms like a lack of sleep, fatigue, depression, hot flushes and mood swings can make your memory and concentration worse. Changes to your ability to remember things and concentrate can be really scary, and lead many to think they have more serious conditions like dementia. The impact on your ability to do your job, and maintain your daily routines can also have far reaching consequences for women’s overall wellbeing.

Memory and mood

If you are depressed or anxious it can be hard to concentrate. Treatments with Cognitive behaviour therapy, hormones replacement therapry (HRT) or other medication may help.

Are changes to your memory permanent?

No - many women find that their memory and concentration returns to normal after their hormones have settled down after menopause. This is, of course, as long as you are not found to have a different underlying health condition.

The symptoms of menopause can last for up to 10 years, which is a long time to potentially be coping with memory difficulties or brain fog. There are steps you can take to help with your cognition - both with HRT and lifestyle changes.

Evidence that hormone replacement therapy can help

HRT can help improve women’s quality of life and manage their menopause symptoms very effectively. The principle is that the lowest possible dose to manage your symptoms should be taken, and you must have a full health history taken before the medication can be effectively prescribed. There are many different types of HRT, and finding the right one for you is important. This can take some time (though it doesn’t always).

Women struggling with memory problems alongside other menopausal symptoms may find that HRT really helps. Often women feel that they have more motivation, energy and focus when they find the right HRT.

There are some scientific studies to suggest that cognitive outcomes may improve with the use of HRT, and emerging evidence that HRT use may reduce the risk of dementia. However, the evidence base in this area is still developing.

There are some health risks attached to HRT, and the size of those risks will always depend on your personal health history. Anyone prescribing HRT should always warn you of the risks, as well as explain the benefits.

Other ways to manage changes to your memory

Not all women can take HRT, and not all women want to. There are steps you can take to change your lifestyle which can help you to manage the impact memory changes are having on your life.

Take steps to help your sleep. This might include reducing caffeine; reducing alcohol intake; sleeping in light clothes; limiting your phone/screen time before bed; and keeping your bedroom cool.

Try doing some light exercise. When your brain is foggy going for a brisk walk or run can really help you clear the fog. The activity releases endorphins, and it will also help to make sure you’re tired before bed. Physical activity has been proved to improve physical health, and brain function.

Tell people about your memory or concentration problems. Whether this is at home, or at work, it can make a huge difference to limiting the impact of cognitive changes on your overall life. If you’re struggling to remember presentations at work then ask someone to split the presentation, or be on hand to step in if you forget halfway through. People can only understand you if they know what you’re experiencing.

References:

1 Hillard, T., Abernathy, K., Hamoda, H., Shaw, I., Everett, M., Ayres, J. and Currie, H., 2017. Management Of The Menopause. 6th ed. British Menopause Society.

2: Nice.org.uk. 2015. Overview | Menopause: Diagnosis And Management | Guidance | NICE. [online]
Available at: https://www.nice.org.uk/guidance/ng23.