--- title: "Navigating Menopause: How to Manage Cognitive Changes with Ease" entity: "blog" canonical_url: "https://www.dramytung.com/blog/cognition-mood-and-sleep-in-menopausal-transition-navigating-changes-for-better-well-being" markdown_url: "https://www.dramytung.com/llms/blog/cognition-mood-and-sleep-in-menopausal-transition-navigating-changes-for-better-well-being" lastmod: "2024-09-11T13:58:00.000Z" --- Menopause: Managing Cognitive Changes Menopause is a milestone that marks the end of a woman's reproductive years. It can also be a time filled with physical, mental and emotional shifts. As one's body adjusts, changes in a women's cognition, mood, and sleep can be experienced. Research shows that up to 60% of women experience cognitive changes, mood shifts, and sleep disturbances during the menopausal transition. The good news is there are tools that women can use to manage and to cope with these changes. Menopause marks the end of your reproductive years and the average age in North America is 52 years of age. It officially begins 12 months after your last period. Before menopause, you go through perimenopause - the time of transition into menopause and this time period can last anywhere from 2-10 years. During perimenopause, your periods may become irregular, the flow may change (heavier or lighter), you may experience hot flashes, night sweats, and/or mood changes. But some women have minimal or only select symptoms as the perimenopause experience is very specific to each woman. I tell my patients that if they are in their mid to late 40's then they are for sure in perimenopause - with or without symptoms based purely on their age. ## Hormone shifts during perimenopause Your ovaries produce less estrogen and progesterone as you approach menopause. These hormonal fluctuations can cause various symptoms. Estradiol, the main form of estrogen, decreases significantly and progesterone production becomes more irregular (common in perimenopause) with each cycle before it ultimately stops as or she "runs out" of follicles (menopause). Estrogen acts as a neurosteroid in the brain. It helps protect neurons and promotes neuroplasticity. As levels fluctuate, you might experience temporary cognitive dips which can lead to: - Hot flashes - Vaginal dryness - Mood swings - Sleep problems - Brain fog Follicle-stimulating hormone (FSH) levels rise as your ovaries become less responsive. This can sometimes be tested by your primary care provider after 1 year with out a period to confirm menopause. ## The Impact of Hormones on Cognition Hormones play a crucial role in your cognitive function during menopause. They affect your memory, thinking skills, and mental clarity. ## Cognitive Function and Memory As you go through menopause, you might notice changes in your ability to recall names or walk downstairs and say to yourself, "why did I come downstairs again?". Estrogen levels affect your cognitive performance, especially in areas like memory and attention. The reason these changes occur are because our brain's prefrontal cortex is sensitive to estrogen. This area helps with: - Planning - Decision-making - Working memory When estrogen drops, you may find these tasks more challenging. But the good news is that this is normal, and your brain can adapt. ## Hormonal Fluctuations and Sleep Patterns Your hormones change a lot during menopause. These changes can affect your sleep. Estrogen and progesterone levels drop, which can lead to sleep issues. Lower hormone levels can cause hot flashes and night sweats. These can wake you up and make it hard to get back to sleep. Some women find that hormone therapy helps with sleep problems. Your body's natural sleep-wake cycle may also change. You might feel sleepy earlier or wake up earlier than before. It's important to listen to your body and adjust your sleep habits as needed. It's important to discuss potential risks and benefits with your healthcare provider. They can help you choose the best option based on your symptoms and health history. ## Neuroprotective Effects of Estrogen Estrogen acts as a powerful neuroprotectant in your brain. It helps shield your neurons from damage and promotes their survival. This protective effect is particularly important as you age. The hormone stimulates neurogenesis, the formation of new neurons, in areas like the hippocampus. This process is vital for maintaining cognitive function and potentially reducing the risk of neurodegenerative diseases. Estrogen also supports myelin formation, which is essential for proper nerve signal transmission. It helps maintain the health of glial cells, which support and protect your neurons. In the cerebral cortex, estrogen influences glutamate signaling. This affects your brain's excitability and can impact cognitive processes. The hormone's interactions with various signalling pathways contribute to its neuroprotective effects. The most commonly asked question by my patients, "At what point in the menopausal transition does brain fog typically resolve"? Brain fog often improves after menopause. For many women, it clears up within a few years of their last period. But everyone's experience is different. Some may have longer-lasting symptoms. ## Tools that can keep your brain healthy - Stay mentally active by learning new skills, taking up a new hobby, reading, doing puzzles, etc - Exercise daily to improve brain health, a minimum of 150 minutes a week but more is better. - Optimize your sleep - Optimize your diet and eat a well balanced diet - consider following the MIND diet (a combination of the Mediterranean Diet and the DASH diet) - eat lots of vegetables and fibre and reduce sodium or salt intake, incorporating fish into your diet (omega 3 intake) - Hormone replacement therapy (discuss with your primary care doctor if this is an option for you and if you are also experiencing symptoms of hot flashes, night sweats, etc - Stress-reduction techniques like meditation, yoga, breathing exercises, going for walks, spending time in nature, cognitive behavioural therapy (CBT) Talk to your doctor about what's best for you. There are many ways to feel better during menopause. You don't have to suffer alone. If you would like to book a free discovery call with Dr. Amy please book in [here](javascript:WebPlatform.Popups.show(5);) or reach out to us by email [info@dramytung.com](mailto:info@dramytung.com) To your best health, Dr. Amy Tung, ND References: Gava G, Orsili I, Alvisi S, Mancini I, Seracchioli R, Meriggiola MC. Cognition, Mood and Sleep in Menopausal Transition: The Role of Menopause Hormone Therapy. Medicina. 2019; 55(10):668. https://doi.org/10.3390/medicina55100668 Soares, Claudio N. MD, PhD, FRCPC1; Maki, Pauline M. PhD2. Menopausal transition, mood, and cognition: an integrated view to close the gaps. Menopause 17(4):p 812-814, July 2010. | DOI: 10.1097/gme.0b013e3181de0943 Baker, F. C., de Zambotti, M., Colrain, I. M., & Bei, B. (2018). Sleep problems during the menopausal transition: prevalence, impact, and management challenges. Nature and Science of Sleep, 10, 73–95. https://doi.org/10.2147/NSS.S125807 Schaedel Z, Holloway D, Bruce D, Rymer J. Management of sleep disorders in the menopausal transition. Post Reproductive Health. 2021;27(4):209-214. doi:10.1177/20533691211039151 Caretto, M., Giannini, A., & Simoncini, T. (2019). An integrated approach to diagnosing and managing sleep disorders in menopausal women. Maturitas, 128, 1-3. https://doi.org/10.1016/j.maturitas.2019.06.008 Woods, N. F., Mitchell, E. S., Schnall, J. G., Cray, L., Ismail, R., Taylor-Swanson, L., & Thomas, A. (2013). Effects of mind–body therapies on symptom clusters during the menopausal transition. Climacteric, 17(1), 10–22. https://doi.org/10.3109/13697137.2013.828198 ## Interested in learning more about working with me? Book a free discovery call virtually (Ontario residents only). Book Now