Below is an excerpt from Dr. Barbara Koltuska-Haskin’s How My Brain Works: A Guide to Understanding It Better and Keeping It Healthy. Her new book offers readers foundational information about the workings of the brain as well as ways to maximize its functions.
Menopause and Memory
Memory and other cognitive problems experienced by women during menopause are real and appear to be more acute in the first year after the final menstrual period (Weber, M. T. et al. 2013). The changes in hormones and natural decline of estrogen affect all women’s bodies, including their brains. Learning and memory are associated with those regions of the brain (hippocampus and prefrontal cortex) that are rich in estrogen receptors. Women may complain of “fuzzy thinking” (Northrup, C. 2002) or “cotton head,” an inability to think straight, organizational problems, attention/concentration difficulties, mood swings, and depression. These commonly are not symptoms of dementia, and memory usually returns to what is normal for the person’s age. However, about 5 percent of women older than sixty have some form of dementia, and the percentage increases as you age; after seventy, it’s 12 percent. I strongly agree with Dr. Northrup, who said, “Women need to know that statistical data on dementia cannot predict whether any particular woman will develop memory problems.” (Northrup 2002, p. 566).
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Janet was a fifty-three-year-old nurse, tall and elegantly dressed, who was referred to me by her physician. Visibly anxious, she stated with tearful eyes and trembling voice: “I may have the beginning of dementia.” When asked detailed questions about her problems, she said she had been forgetful for the past few months and was making stupid mistakes at work. She had no family history of dementia, but her best friend’s husband had been recently diagnosed with early-stage Alzheimer’s. She had noticed him having memory problems, and was afraid she could be experiencing similar problems as well.
After talking for a while to make her more comfortable, I explained that memory complaints aren’t necessarily memory problems, and told her what kind of testing we would be doing. I mentioned that most patients with dementia have problems with judgment and insight, and tend to be in denial about their memory and other cognitive problems. Most of them are brought for evaluation by family members who see changes in their functioning that are not obvious to the patients themselves.
This made Janet feel more comfortable and eager to start testing. She mentioned that she had been menopausal for the past year and wondered if that might have something to do with her cognitive functioning difficulty.
Testing found that her memory was generally within the normal range for her age, and her verbal memory was above that range. She exhaled with relief. I explained that some menopausal women experience memory and cognitive problems, especially in the first year, but that it usually comes back to normal. Therefore, Janet’s memory may have been somewhat higher before menopause, but at present, there was no reason for her to worry. She was advised that we had good baseline results for her memory functioning, and she could return for retesting if she had concerns in the future. She might also benefit from therapy to help her deal with anxiety and stress at work. She called several weeks later thanking me and telling me she was doing much better.
Janet’s story isn’t that uncommon. In my clinical practice, I see several middle-aged women a year who are experiencing memory problems and are afraid they’re having the beginnings of dementia. The fear of losing their mind and being unable to function causes them sadness, depression, and insomnia, and significantly affects their quality of life. So if you experience this problem, instead of dwelling on the unknown, talk with your physician or other health care provider about whether you can benefit from a neuropsychological evaluation. The memory tests have specific norms for every age. They will help find out if, in fact, you have memory problems or merely memory complaints, and if you have problems, what kind they are, verbal or visual, or which memory processes, retentive memory or encoding, are affected. This specific information will allow the neuropsychologist to give you detailed information as to what you can do to improve your overall functioning and the quality of your life.
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Please remember this: Most of the time, you can improve your brain functioning, even after a major neurological event or illness. You simply need to find the best and most effective way of doing it with the help of your health care professionals. Take the example of Dr. Jill Bolte Taylor, a neuroscientist who recovered quite well after a massive stroke and wrote a fascinating book, My Stroke of Insight: A Brain Scientist’s PersonalJourney (2008).
About Dr. Barbara Koltuska-Haskin:
Dr. Barbara Koltuska-Haskin is a neuropsychologist in private practice in Albuquerque, NM. In addition to her research and academic teaching background, she has over 30 years of clinical experience and was recently invited to become an official contributor to the Psychology Today Magazine Online. She is a classically trained mezzo-soprano with a deep love for organic gardening. You can purchase her book on Amazon. Learn more at: https://www.drkoltuska.com/ or https://www.facebook.com/barbara.koltuskahaskin/