Does menopause affect your memory?
Does menopause affect your memory?
A third of a woman’s life – if she’s lucky – will spend her post-reproductive years. But very little research has been done on what happens in the brain during this transition, which we call menopause and the period after it.
PhD, neuroscientist and professor Emily Jacobs, studies how hormones affect women’s cognition and brain function. “Menopause is not a disease, and it is not something to be feared,” says Jacobs. “It’s a normal part of life.” Through her research, Jacobs is exploring the many neurological aspects of this transition so women can better understand what’s going on with their minds and bodies. Here, she guides us through the fascinating nuances of the effects of menopause on memory and the brain.
Q&A with Emily Jacobs, PhD
The good news is that cognitive changes tend to be subtle. Anecdotally, a lot of women are just fine and they’re definitely being extremely productive. Women don’t fall off some proverbial cliff.
That said, about 80% of women will self-report some symptoms, including hot flashes, brain fog, sleep disturbances, and mood swings. We need to understand two phenomena: women with very few symptoms and women with these symptoms are real.
Menopausal fog or brain fog refers to a set of cognitive changes that are often transient. During perimenopause, hormone levels fluctuate and they eventually drop to very low levels in post-menopause. This menopausal transition, when hormone production changes more than usual, can lead to changes in thinking, learning, and memory. These changes are also apparent after surgical menopause (removal of one’s ovaries).
Sometimes these cognitive changes are the result of sleep and mood disturbances. If a woman is experiencing strong vasomotor symptoms, such as hot flashes, those symptoms can affect sleep quality. Poor sleep quality and depressed mood are harmful outcomes for brain health and cognition, so addressing sleep can also help address other eventual effects.
If these symptoms involve or affect your quality of life, talk to your doctor, but also know that they may subside in the post-menopausal period as hormone levels stabilize again. .
We found reliable changes in verbal fluency and verbal memory – forgetting a word or a name, for example.
Throughout life, women have stronger verbal memories than men, and this begins around puberty. That advantage is lost in postmenopausal women. Premenopausal and perimenopausal women outperform men in age, but by the time women enter the postmenopausal phase, they perform at the same level as men of the same age. It’s an area that’s particularly sensitive to hormone decline. These drops can be statistically significant, but the size of the effect is small, so for many women it doesn’t affect quality of life.
Changes in working memory and short-term memory are very small. (Working memory is the ability to remember information for a short period of time. It’s like your mental sketch.) Working memory and short-term memory are very powerful during the transition. terrible.
If we look below and ask what is happening in the brain, it turns out that there are interesting changes. At the behavioral level, memory performance did not change significantly during menopause. However, the brain seems to use slightly different mechanisms and relies on a different network of brain regions to maintain the same high level of performance.
Diet, exercise, sleep and cognitive functioning are all important throughout life, including the transition to menopause. If you’re experiencing symptoms (hot flashes, vaginal dryness, bone loss, mood or cognitive changes) in midlife, schedule a doctor’s appointment and advocate for your health needs. . If they eliminate your symptoms, find a new provider who can support your health. There are many approaches, including hormone therapy for some women, that can help reduce pain and increase quality of life.
Women go through the menopausal transition differently. Some women don’t realize they’re going through it, for example if they’re on medication and their hormone levels are already low. They switched and didn’t notice much of a difference. For other women, they will experience noticeable changes.
What can be truly empowering is simply talking about the experience with your friends, partners, and family members. Normalize the experience. People will begin to appreciate the varied experiences that menopause can bring.
You could be doing all the right things and you could still have these symptoms, and that’s okay. It doesn’t mean you’re doing something wrong, but this is an opportunity to talk to your doctor and consider other approaches that can ease the transition.
The largest randomized controlled trial on the risks and benefits of hormone therapy is the Women’s Health Initiative study. Previous findings from the study suggest that hormone therapy is associated with an increased risk of cardiovascular disease and stroke. These results flooded the media and prescriptions for hormone therapy dropped overnight.
Twenty years later, we now understand that age matters. The women in the study were all several years past menopause. In some cases, these were women aged 65 to 75 who received hormone therapy for the first time after they transitioned. The brain and body of a 75-year-old who hasn’t experienced estrogen in 20 years may react differently than a woman in her 50s.
We now understand that there is this opportunity – the idea that if hormone therapy is started during perimenopause or early menopause, it will have more benefits and less risks than if it were started. 5 years or more after conversion. The official statement from the North American Menopause Society is that for many women, hormone therapy can be safely used in middle age and that the benefits of hormone therapy outweigh the risks.
If you are under age 60 or within 10 years of the onset of menopause and have symptoms that affect your quality of life, talk to your doctor and ask about the risks and benefits of starting menopause. start hormone therapy.
It starts with education. Eighty percent of medical schools do not include menopause in their curriculum, and at those schools, courses are mostly electives. Let’s be clear: The female body is not an option. The majority of graduate neuroscience professors are male. This ignorance is not malicious, but it is born out of inexperience. Menopause is never seen for them. They lack the experience to picture menopause as a phenomenon worthy of study – and this is perhaps the strongest argument for diversity in science. Increasing the diversity of scientists means we will increase the diversity of science.
One of the biggest challenges in cognitive neuroscience is understanding what happens to the brain as it ages. Over the past 30 years, the dominant model has been to study adults 65 and older and compare their brains with the brains of young people in their 20s. The number 65 is a historical artifact based on retirement age. the average of wage earners in the United States. From a women’s health perspective, it’s an absurd age to choose because it ignores one of the most profound neuroendocrine changes in a woman’s life, the transition to menopause. terrible.
I’ve spent the better part of a decade fighting for women’s health to be taken as seriously as men’s in biomedical science. And there are other incredible scientists working on this front. But we cannot do it alone. Biomedical research has overlooked too much women’s health. Women make up 52 percent of the U.S. population, we control 60 percent of our personal wealth, and we make 80 percent of health care decisions. It’s time for science to serve our needs.
Related Reading Episodes and Podcasts
Gwyneth Paltrow x Taz Bhatia: Understanding perimenopause and menopause
A Beginner’s Guide to Hot Flashing
Understanding menopause and perimenopause
Emily Jacobs, PhD, is a neuroscientist and professor at UC Santa Barbara. Before joining UCSB in 2016, Jacobs was a faculty member at Harvard Medical School. Her research has been featured in many publications, and Jacobs was named the Kavli Frontiers of Science National Academy of Sciences for Outstanding Young Scientists Under 45.
This article is for informational purposes only, even if and notwithstanding the advice of doctors and other medical professionals. This article is not, nor is it intended as a substitute for, professional medical advice, diagnosis or treatment and should never be relied upon for specific medical advice. The views expressed in this article are those of experts and do not necessarily represent the views of goop.