Help! Menopause Just Stole My Brain!

Menopause stole my brain | CU OB-GYNFor the majority of women, menopause is a natural transition that does not appreciably affect their ability to cope with daily living.

I don’t know about you, but sometimes I feel less than charitable towards that majority! My own menopause left me with a short-term memory deficit that has since improved, but my memory has not gone back to what it once was. Moreover, my near-perfect ability to see a patient of mine and remember her name immediately—is gone for good. I struggle mightily to conjure up names, and they are just not there.

Most menopausal women, upon losing their car keys (or wandering into a room of the house, only to stand there, perplexed, unable to remember why they got up and went into that room), feel a sense of loss and alarm at these cognitive symptoms. They worry that they are getting Alzheimer’s Disease, and fast-forward to a nursing home future. Yet, such symptoms are completely normal and seen in both men and women in association with aging.

The way I understand it, the brain stores information in two bins. One is short-term memory and one is long-term memory. On its way to the short-term memory bin, awareness is acquired in a ‘working memory’ zone. ‘Working memory’ is more of a systems concept, and refers to the way in which the brain organizes information and prioritizes its inflow. It is working memory and short-term memory that become disrupted during the menopausal transition. Each of these may become disrupted for a different reason.

The relationship between hormones and memory is not well understood, but the withdrawal of estrogen that is characteristic of the latter part of the menopausal transition (when women start skipping menstrual cycles) is associated with more short term memory difficulty. This can be severe in some women, and causes great concern.

A failure to remember appointments, items on shopping lists, or facts that you have just read, can be disturbing. A patient once told me that the experience that had motivated her to come to my office was the morning when she had to ask her husband to tell her how the movie they had both watched last night had ended! Needless to say, she was very relieved to hear that this kind of experience is not so unusual.

For others, working memory gets disrupted, and an inability to perform what is called ‘executive function’ types of tasks gets disrupted. Women who had previously had no problem organizing their thoughts into writing now find that some days are just impossible for them to write. Others find that prioritizing tasks and motivating themselves becomes a major challenge. Working memory disruption may be more linked to physical problems that accompany menopause, such as sleepless nights, and bodily discomforts (such as relentless hot flashes) that are distracting and erode one’s ability to control information inflow. The result can be information overload and mental paralysis of sorts.

If you are menopausal and suffering from these kinds of cognitive issues, you should take heart and recognize a few things:

  • Such changes are normal. It’s OK to have a lapse of memory here and there. As I tell my patients: not being able to remember where you put your car keys is not unusual; but if you are holding your car keys in your hand and having trouble remembering what they are for, that’s a possible problem!
  • Observe your partner or friends of the same age. Chances are they are standing in doorways looking perplexed, too!
  • A variety of memory aids are available on the internet or by DVD. Using these tricks usually involves deliberately linking information and sorting them into images (the bigger and more outlandish the better) to jog the memory. Poker and blackjack players and use these techniques to memorize cards.
  • It’s likely to improve when menopause is complete. Once the hormonal bounces of menopause are over, most women re-stabilize and note an improvement.
  • If you can manage or treat your major symptoms, the cognitive issues may get better as a result. Severe hot flashes or sleeplessness from any cause ought to be treated. As these symptoms improve, the cognitive issues may subside.
  • There are treatments available. Women who took hormones during their menopause transition (but not afterwards) had better cognitive function than those who did not, especially in the short-term memory realm. If you are in the throes of menopause and are having a rough time with memory symptoms, consider hormone treatment. If it doesn’t work within a few months, you can stop it, and if it does, it will ease the stress.
  • For women who suffer from a failure to organize, there is some new research indicating that a mild attention-deficit disorder medication may offer relief for menopausal aged women.

Well, that’s all for now. I have to go…somewhere, but, um, I can’t find my car keys…