As a child I always prided myself on my memory. I could and still can remember specific childhood events as early as age 2 in vivid detail. Things started to blur during residency when I worked 36-hour shifts but nothing destroyed my memory  (as well as other body parts) like children.
The deep slide occurred after the birth of my twins when I boiled my breast pump after forgetting I left it on the stove.  The toxic smell of burnt plastic required the fire department to come and air out our apartment. That certainly ruined my chances for mother of the year. I realized 2 things. Hot soapy water is sufficient to clean a breast pump and hormones made me stupid. Certainly sleep deprivation had much to do with it but I remember the moment that I stood in the kitchen and realized my fantastic memory had slipped and I knew that it was related to my hormones.  Fortunately, my memory returned but I can’t wait to see what happens when I hit menopause.


2/3 of women will complain of memory problems during perimenopause or that 5-10 year transition time before they go through menopause or stop their periods.
A recent study in a May issue of Neurology confirmed what many women already knew. It showed that it was not so much their memory, but women’s ability learn or process new information that declined right before menopause. The good news is that it returned to normal after menopause.

Why would perimenopause hurt your memory?

There are several theories.
We know that stress affects memory and brain function at any age. Perimenopause is a very stressful time for women. They are dealing with their children, aging parents, careers and older studies showed many times women were simply over extending themselves. They were multi tasking so much that they were not actually processing new information.

It has been said that it takes 8 seconds of concentration to learn something new. Many women don’t seem to clear out the other conversations they have to really learn new information (or enjoy sex for that matter). For example, a woman might be listening to her doctor but also thinking about picking up the kids and what to have for dinner. Later, she may not remember what the doctor said because the information wasn’t ever there. She didn’t focus exclusively on it to transfer the information to her long-term memory and really learn it.

Depression also affects memory and is very common during perimenopause. In fact, I found mood swings to be the most common and first sign of perimenopause in many patients. “I think that I am fine but my husband and kids think that I am a bitch!”
Fluctuating estrogen levels of perimenopause certainly can cause mood issues but it may also play a role with memory.

What can we do if experiencing these memory lapses?
There are many things we can do to prevent memory loss both in perimenopause and with aging.

Like any organ in our body, our brain needs to be exercised. We must use it or lose it.
1.    Aerobic exercise like walking will increase the blood flow to the brain and improve the chemical messengers. Exercise may actually decrease the risk of Alzheimer’s.

2.    Mental exercise is also important. Puzzles like Soduku have been shown to increase memory. Not everyone has time for play puzzles so it can also be as simple as brushing your teeth with your nondominant hand or left handed for most people.  When you are in the grocery store try to memorize the list of items down the aisle in order. The goal is to challenge your mind to build new synapses or connections in the brain.

3.    Stress reduction is so important for overall health but plays a big role in memory too. Mindfulness or paying attention to what is going on instead of the constant to do list in your head will especially help perimenopausal women to focus and process new information.

If you want to remember something chunk it down into smaller manageable bits or create a visual association with it. We often forget someone’s name when we meet him or her. Part of the problem is that our brain is worrying about how we look or something else, so we are not focusing on learning their name.

To help focus and learn, create a mental picture that has to do with the person’s name.  My name is Rouse-Raines. One could visualize a house in the rain. House, rhymes with rouse, in the rain creates a picture to remember Rouse-Raines.

4.    Healthy Living is key. Get sleep, avoid alcohol and smoking. Like I always say, put junk in and you will get junk out.  Too much alcohol pickles the brain and smoking deprives it of essential blood flow.
There are certain brain foods that are high in anti oxidants like blueberries, green tea and reseveratrol that we’ve talked about. They rid the body of toxins, which is even more important as we age. Omega three fatty acids found in salmon and walnuts are important brain nutrition.

What about estrogen?
We know that estrogen will not help postmenopausal women prevent or treat dementia.  You don’t want to start estrogen in your 60s when you have been deprived of it for so many years. This will cause more damage than good on many levels.
Estrogen does improve mood in perimenopausal women, which may help memory.
If mood or anxiety is your only symptom in perimenopause then a super low dose of an SSRI like Celexa or Lexapro even if only during the second half of the cycle can make a huge difference in mood and memory without side effects.
If you are having bleeding, hot flashes and mood swings then I would talk to your doctor about adding estrogen first. There are many ways to add this and should be tailored to your symptoms. Many women benefit from added estrogen plus and SSRI during this transition.
Evidence does indicate that starting estrogen before a woman’s period stops will help with memory and cognition and may even prevent later dementia.

Afraid this could be dementia or something more?
Forgetting where you put your keys or where you parked is normal. Forgetting how to get to the house that you have lived is in not. Click here for more information about dementia.

Slow down, take a deep breath and savor and you’ll be surprised how much you’ll remember, like a child, how wonderful life can be.
Peace,
Dr. Deb