Have you ever walked into a room, forgotten why you’re there, or blanked on a word you swear you just knew? You aren’t alone. During perimenopause and menopause, cognitive changes like brain fog, mood, and forgetfulness are common due to decreases in estrogen. But just because it’s normal doesn’t mean you have to live with it. June is Alzheimer’s and Brain Awareness Month, and it’s the perfect time to empower you to nurture your brain throughout midlife, manage symptoms, and protect your brain health.
What is Alzheimer’s?
Alzheimer’s disease is often used as a catch-all term for cognitive decline, but it specifically includes a condition where brain cells no longer function the way they used to. Alzheimer’s disease is often caused by the buildup of sticky plaque between brain cells, which blocks communication and disrupts the function of those cells. Another form of dementia happens when small blood vessels in the brain become blocked, causing tiny strokes. These tiny strokes slowly damage healthy tissue, which is then replaced by scar tissue that no longer does its job. In both cases, when form and function are disrupted, so is our ability to think, remember, and focus.
Our brain is composed of complex networks of cells and neuropathways, all interconnected by electrical signals and supported by blood vessels. When the communication system between the brain and the rest of the body breaks down, whether due to plaque, inflammation, or reduced blood flow, brain function suffers.
Brain Fog vs Dementia
While it can be a scary feeling when our brains don’t seem to be working the same way, it doesn’t mean you have dementia. Brain fog, forgetfulness, and difficulty focusing are all symptoms of perimenopause and menopause. While both dementia and menopause involve memory changes, they show up differently. For example, if you walk into the kitchen and forget why you went there or that you needed a spoon, that’s frustrating, but normal. What’s more concerning is forgetting how to use a spoon.
Symptoms of brain fog and forgetfulness caused by menopause are not the same as dementia. When someone has dementia, higher-level thinking skills, such as cooking, baking, or managing finances, become difficult. These activities require multiple steps, like following a recipe, remembering what’s in your kitchen, and measuring out ingredients. A key indicator that forgetfulness is more than just a menopausal symptom is when individuals start to lose these specific types of abilities and are unaware that they are.
Brain Fog With Stress
Brain fog can show up when you’re stressed, sleep-deprived, or having hot flashes. For example, even if you prepared for a presentation, your mind may go blank. Many menopausal symptoms can add to an already stressful situation, and our minds can go into fight or flight. Fight or flight shuts down the prefrontal cortex, the part of the brain responsible for logic and critical thinking, to prioritize a way to escape. During these heightened states, your brain enters a state of cortical deactivation, which powers down the part of your brain responsible for memory recall and critical thinking.
During these frustrating situations, we can ground ourselves by focusing on breathing and practicing gratitude. Dr. Herbert Benson at Harvard found that gratitude is a powerful tool for resetting and bringing the brain back online. Before Dr. Benson goes on live TV, she pauses, takes a breath, and thinks of something she is grateful for. If you are struggling with brain fog or forgetfulness during periods of high stress, try this practice before your meeting or a difficult conversation to help calm yourself and activate your brain.
The Busy Mind
When estrogen levels decline during perimenopause and menopause, it can have a significant impact on our brain chemistry and function. Estrogen helps regulate key essential neurotransmitters, such as GABA, serotonin, and norepinephrine, which support our mood, focus, and emotional balance. When estrogen drops, women can experience increased anxiety, mood swings, and a “busy mind” that is stuck ruminating and overthinking. A simple worry, like your child’s grades, can turn into spiraling thoughts and conclusions not based in logic, such as, “they will never succeed.” A mental loop like this can be due to a loss of estrogen, especially when other factors like unmanaged stress, chronic pain, or poor sleep are also occurring.
Why Estrogen Matters
As women, our bodies move through natural cycles of estrogen shifts, rising during puberty, fluctuating each month, and declining during perimenopause and menopause. These hormonal changes influence how our entire body and brain function.
Estrogen has a significant role in protecting our brain health. We have estrogen receptors throughout the brain that control inflammation, support blood vessel health, and facilitate effective communication between brain cells. Without estrogen, the blood vessel walls become more sticky, allowing fat to stick and start forming plaque. This leads to increased inflammation, and the plaque becomes gummy and irritated, potentially affecting our brain’s function. Estrogen also plays a key role in neuroplasticity, enhancing the brain’s ability to adapt and grow. Without it, our ability to be adaptable to our environment can become harder, causing new challenges and stressors for women in menopause.
Healthy Habits For Brain Health
At true., we use SEEDS® to help support our patients’ development of healthy habits. We encourage you to reflect on the barriers preventing you from healthy aging and start small by implementing one of these habits this week. Our habits play a significant role in our brain function and managing menopausal symptoms. Here are a few healthy habits and how they support brain health:
- Sleep is essential for brain recovery, memory storage, and overall brain function.
- A balanced diet rich in fiber, protein, and healthy fats, provides fuel for our brain.
- Exercise, such as strength training, reduces blood sugar and inflammation.
- Supplements like magnesium, omega-3s, and GABA support brain function.
- Staying hydrated has a significant impact on mood, temperature regulation, and mental focus.
- Nurturing our mind-body connection helps ground us in times of heightened stress and reduces stress hormones.
Potential Benefits of GLP-1s On Our Brain Health
GLP-1s reduce blood sugar and fat, lower inflammation, and may protect the brain. The primary role of these medications is to mimic essential hormones produced in our GI tract and circulate throughout the body, including the brain, to signal that we have eaten. That signaling influences the secretion of sugar and fats into the rest of the body, having a snowball effect that helps reduce inflammation both within cells and at the blood vessel level, potentially preventing the scarring and tiny strokes linked to cognitive decline. While GLP-1 drugs aren’t FDA-approved for dementia prevention, experts in obesity medicine believe they can have a significant impact on improving our overall cognitive health.
Aging Healthy With true.
If you’re in perimenopause or navigating menopause and struggling with brain fog or forgetfulness, you’re not alone. Talk to your doctor about treatment options and how to optimize your brain health, so you can confidently embrace midlife. At true., we believe every woman deserves to be empowered with knowledge and resources so they can be equipped to take their health into their own hands.
Five Take-Home Tips:
- Think about your Picture Of Self in old age.
- Take the MTS (Menopause Transition Score) to track symptoms.
- Know that your metabolic health and brain health are connected.
- Don’t be afraid of Menopausal Hormone Therapy (MHT) and your brain health; if anything, be excited!
- Reflect on your barriers to optimize your SEEDS®, especially sleep.
Five Questions For Your PCP:
- What is my phase of ovarian function?
- What are your thoughts on Menopausal Hormone Therapy?
- How is my metabolic health, and what tools do you have for me to optimize it?
- What are my resources for building muscle mass?
- Can you help me with stress management?
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