Reviewed by Brian St. Pierre, MS, RD and Helen Kollias, PhD
It’s like my thoughts were under a pile of garbage.
On a Friday night, as my husband and I tried to figure out where to eat, a typical conversation would go like this:
Me: Do you want to go to that restaurant?
Him: What restaurant?
Me: I can’t think of the name. We’ve eaten there before. It’s that place with the peanut shells on the floor? It’s next to… You know… It’s on that road where we used to take the dog to the vet. Do you know the one I’m talking about??
It was as if certain details got lost in a pile of sludge in the deep recesses of my brain. Then, hours later, the details would escape, and I’d shout into an empty room…
“Texas Roadhouse!”
Sludginess with proper nouns is typical for people who are middle-aged and beyond.
However, what seemed to be happening to me, increasingly in my late 40s and early 50s, felt far from typical.
Not only could I never seem to spit out the names of various restaurants or people or books or movies or so many other things, but my brain was also pooping out during the workday.
I’d sit in front of my computer screen, stare at a document, and will myself to do something constructive with my fingertips. Everything seemed hazy, like those first few moments in the morning when you’re awake enough to turn off the alarm but too sleepy to do basic math.
I had my good moments, usually in the morning, when I attempted to pack eight hours of writing into the two or three hours I possessed mental clarity.
On my worst days, however, I awoke with a haze I never managed to shake. Work was a non-starter. Nor did I have enough bandwidth to read, or do much of anything, really.
I sought medical advice.
Three healthcare professionals recommended antidepressants. I tried one, and felt even worse. I tried another. I tried yet another at a higher dose. Still, I felt like a zombie. Another professional gave me a sleeping pill. It left me feeling even more drugged.
Someone tested my thyroid. There was nothing wrong with it. Nor was I anemic. I tried supplements, mushroom coffee, and just about any product with the word “think” somewhere on its label.
Finally, after nearly two years of seeing a revolving door of doctors, I made an appointment with a gynecologist for my yearly exam. I mentioned vaginal dryness. That information triggered her to ask a string of questions that had nothing to do with my undercarriage. How was my sleep? Mood? Energy levels? Was I experiencing hot flashes? How about brain fog?
“Funny you should mention brain fog,” I said in my usual hazy monotone. “I feel like I’m barely alive.”
By the end of the visit, I understood that I’d likely never had depression.
What I “had” was menopause.
My gynecologist sent me home with prescriptions for estradiol and progesterone.
Within days, it was as if someone had flipped a switch.
I could think again. I could type words again. I could follow conversations. I could work past noon.
And, for the first time in years, I could sleep more than two hours without waking.
They may also be dealing with the challenges of parenting angst-filled teens, caring for aging parents, adjusting to an empty nest, questioning their marriage, or trying to navigate financial issues such as deciphering statements from the college bursar or hospital billing department.
However, one often overlooked trigger for cognitive discontent is the hot flash, a common menopausal symptom.
Hot flashes and night sweats, known as vasomotor symptoms, are caused by changes in blood vessels and hormone levels. These symptoms can lead to physical sensations such as warmth, sweating, heart palpitations, and anxiety. The underlying cause of hot flashes during menopause is believed to be related to the hypothalamus, the part of the brain responsible for regulating temperature.
Recent research has shown that hot flashes may have a more significant impact on health than previously thought. They can affect blood vessels and brain function, potentially leading to cognitive decline. Studies have found a correlation between frequent hot flashes and changes in blood vessels, as well as an increased risk of developing conditions such as dementia and stroke.
Frequent hot flashes can also disrupt sleep, impacting memory consolidation and emotional regulation. Many women may not realize that hot flashes are affecting their sleep, attributing their symptoms to other conditions like insomnia or sleep apnea. This lack of awareness can lead to prolonged sleep disturbances and cognitive issues.
Despite the significant impact of hot flashes on cognitive health, healthcare professionals may not always address these symptoms effectively. There is a lack of specific training on menopause-related issues, leading to underdiagnosis and inadequate treatment. Some healthcare providers may be hesitant to prescribe hormone therapy, citing safety concerns.
In light of these challenges, it is essential for women experiencing menopausal symptoms to advocate for their health and seek out healthcare professionals who are knowledgeable about menopause and its effects on cognitive function. They have concerns about the possibility of facing a lawsuit. When individuals spend time outdoors in the mornings, they sleep more easily, longer, and have fewer awakenings the following evening. Sunlight may also enhance mood and concentration.
For individuals who are already fatigued, engaging in long, intense exercise sessions may exacerbate their feelings of tiredness. Injuries are more common as we age, and recovery times are prolonged. It is important to listen to your body and adjust your exercise routine accordingly. Short bursts of exercise can help increase alertness during the day.
Cognitive Behavior Therapy for Insomnia (CBT-I) is a research-based therapy that can help improve sleep quality by teaching skills and changing thought patterns related to sleep.
It is important to assess stress levels and prioritize self-care and recovery. Experimenting with cooling technology and taking frequent breaks can also aid in improving sleep quality.
Following a diet that supports healthy circulation, such as the MIND or Mediterranean diets, can also benefit brain health and emotional well-being.
Menopause can be a challenging time, but it also presents an opportunity to reevaluate priorities and make choices that support overall well-being. It may be beneficial to reassess daily responsibilities and make adjustments as needed to prioritize self-care. Perhaps simplifying the recipes I chose could be beneficial. Additionally, learning to say “no” more often without regret may allow me to prioritize the things that truly matter, such as visiting my aging parents, answering my kid’s calls from college, and taking leisurely walks with friends around town. Despite having regained energy and mental clarity due to hormonal changes and lifestyle adjustments, I still choose to end my workday around 3 p.m. Why? Simply because I can and I want to.
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