You know that feeling in the morning, when you’d rather have complete silence until the morning coffee has had a chance to kick in? 
Or have you ever found the car keys in the fridge? 
Felt paranoid at work, or doubting yourself?

You’re not alone. Many women feel this during menopause.
It’s not just an issue of low energy and lack of sleep, it can be compounded by brain fog, too. A cotton-wool cloud of uncertainty and indecision is often a bitter appetiser for another common menopause symptom; anxiety.

I’ve had many women tell me it’s these somewhat invisible symptoms, which are the hardest to deal with. As a busy woman with a lot on your plate, it can be tricky to know what’s attributable to menopause, or a full diary and a demanding family. 
Some clients have confided their fears to me, saying; “I was scared it might be early dementia” (there is an easy way to know the difference between this and menopause, I’ll tell you later). First, let me reassure you that although brain fog, anxiety are other cognitive issues are extremely common, there are many things you’re able to do, to help yourself. 

Why are brain fog and forgetfulness a symptom of menopause?

Foggy head, forgetting what you were going to say, questioning yourself, words on the tip of your tongue, losing focus, unable to concentrate. Then worrying about how it’s affecting day to day life, fighting through the day and hoping it will improve somehow.  Brain fog and anxiety can be debilitating. 

It’s a ‘perfect storm scenario’, starting with hormonal changes in peri-menopause which affect sleep patterns, energy, memory and brain efficiency. 
Oestrogen, progesterone, follicle stimulating hormone (FSH) aren’t just about fertility and menopause, they’re the original multi-taskers of the body. These hormones also have a role in cognitive health, and some women’s brains are affected by the menopausal fluctuations more keenly than others. 

Oestrogen is often the hormone that gets the limelight here and for good reason. As a neuro-protective hormone, it serves to give protection to nerves and brain circuitry against degeneration.
Also consider that oestrogen assists with building new neural connections, for learning and memory. And you can start to see how reduced concentration of circulating oestrogen can be felt at brain fog.

Why do I feel more anxious?

Anxiety is a repercussion of your whole body being on ‘full alert’ for disaster, waiting for the tiger to leap out at you. No tiger? Oh yes there is. It’s called email alerts from work, phone reminders about what you still need to do, messages from the family, and the list goes on.

Your natural stress management system (the adrenal glands) are doing their best to manage the levels of cortisol and adrenaline as a response to all this potential threat (real or perceived). And your adrenals are also a key player in hormonal balance, for the production of hormones which promote calmness and sleep. 

When you get tired, have trouble sleeping (e.g hot sweats, snoring partners, ruminating, waking up early and not getting back to sleep), wake up groggy-eyed and then drink coffee… we all know it’s a temporary plaster on a problem at that moment. But unfortunately, there is a cost. 

Stimulants like caffeine ask the adrenal glands to do even more work for you, releasing more stress hormones, maintaining the need to stay on ‘high alert’. 
The more busy these glands are, the more likely you are to feel anxious. Many clients have told me how much better they feel, for drinking more water and less coffee, even though they were convinced they needed the coffee!
And whilst we’re talking about tiredness, let’s just mention it’s not always caused by a physical tiredness – it can also be a feeling of being ‘tired of’ the situation you’re in. I know of many 40+ women who can relate to that feeling. 

How do you know if it’s menopause, or dementia?

The correct term for the foggy head feeling, or being a bit forgetful, is MCI (mild cognitive impairment).
For women in menopause, it is temporary. 
Dementia is characterised by an increasing disorientation, difficulty in communication and basic life skills like cooking, dressing. Or forgetting how to carry out everyday tasks that you’re usually competent in, like driving the car for example.

It is important to note that MCI is not the same as dementia but there are some overlaps, and there are many things we can all be doing as preventative measures against the risks of it becoming a problem now, or in later life. If you are looking for further reading here, a good reference would be the book ‘Why isn’t my brain working?’ by Datis Kharrazian. 

Menopause can affect us in so many different ways, but it doesn’t need to be a disempowering experience. 
The hormonal changes are inevitable but the transition can be smoothed when we take into consideration the environment in which the hormones are sitting in… you. 
You see, menopause symptoms – cognitive symptoms included – don’t present themselves solely because of hormone decline.
Hormones aren’t released into a vacuum, they’re secreted into your body. With many other factors and variables at play, many of which, you’re able to do something about.

What can you really do, about mild cognitive impairement?

Whilst many women in my facebook community ask me for quick tips and remedies for this and other menopausal symptoms, I always seek to empower with the knowledge of ‘body systems over symptoms’, rather than encourage a pick n mix approach to supplements and the like. 
Targeted supplements can be useful, but not until you’ve first built the foundations for overall hormonal balance. It’s not at all as laborious as it sounds, as I’ll explain below. 

There has also been much discussion elsewhere on the use of hormone therapy (HRT, body identical hormones), as a way to preserve our cognitive health. Recommended reading includes ‘Oestrogen Matters’ (written by Dr A. Bluming and C. Tarvis). 
However, there is no substitute for nourishing the brain (and body; it’s all attached) with the specifics of appropriate food, movement, and all that I’ve listed below. Dr Lisa Mosconi made reference to this in her popular TED talk (well worth watching if you haven’t already) and her recent book (The XX Brain) is an absolute treasure trove of valuable advice, too.

Brain fog and anxiety – what can I do to help myself, today?

Poor vascular health leads to reduced blood flow to the brain.
In order to prevent hormonal changes from taking the upper hand, daily movement really is a non-negotiable. 

It doesn’t mean you need to join a gym and take up a new sport, however. Many of my clients use the daily dog walk as part of their de-stress and exercise time.
As a former Personal Trainer, I’ve an unlimited supply of ideas to add in a few bodyweight exercises, without it feeling like an extra chore to fit into the day. 
This study talks about the benefits of exercise and movement, for protecting our cognitive health.

As a woman in menopause or even post-menopause, general ‘healthy eating’ advice is no longer specific enough for you!
Don’t panic, it’s not all about wheatgrass and weird organic vegetables you can’t get hold of. It’s simple really.
First things first, how much water are you drinking? If it’s less than 1.5 – 2 litres, then I definitely recommend increasing your intake – whilst gradually reducing any stimulants. Small, manageable changes are definitely more beneficial here.

Food choices to support the brain include vegetables – more so than fruit (particularly green leafy vegetables), oily fish, beans, nuts, seeds, berries, poultry, olive oil. You also need a source of protein and natural fat with every meal. For example eggs, salmon, lean meat, pulses.
Food choices shown to increase the risks for brain fog and anxiety include sugar, caffeine, alcohol, and simple carbohydrates like bread, cereal, granola, pasta. 

Use it, or lose it!
Your brain will adapt and respond well, if you give it the chance.
Brain health is dependent upon nutrition but equally so on stimulus.
There really is potential for neurogenesis (generating new brain cells) even at menopause – you can teach an old dog new tricks!
We’re talking about picking up an old hobby, learning a new instrument or a language, 5 minute ‘brain-training’ games, interaction with nature. Also, fulfilling and stimulating conversation, being part of a community, feeling heard and understood.

Sleep and Rest
Sleep is a busy time for the brain to process and run its clearing systems, so that you’re able to function properly the following day.
It goes without saying that a poor night’s sleep results in reduced focus and productivity, with further impacts on food choices (which then compound the issue). 

I encourage all my clients to ‘book end’ their day, to have a regular routine (even a few minutes) which essentially helps you to power-up and then power-down at the start and end of the day.
Please get in touch if you’re struggling with sleep, I have many strategies I can share with you in a consultation.
Rest and time to recharge yourself is equally important, as it allows the brain to flip the switch into ‘thrive’ mode rather than fight/flight/freeze.

Not a dodgy diet, but a reference to detoxing yourself of unhelpful behaviours, beliefs, patterns, thoughts that are holding you back.
Now is the time to practise self-compassion over self-criticism. To build hormonally helpful habits with baby-steps. And to listen to your gut instinct about what really matters to you. 

Stress and worry don’t remain simply as a thought, they seep out into the brain and affect the body physically and mentally. There are so many things on our list of ‘controlables’ but what could you let go of? What could you accept as ‘out of your hands’?
Keep this in mind; small and consistent will always beat bold and chaotic.

To summarise – What definitely helps with cognitive ability in menopause?

Hobbies and brain training games
Sleep routines
Regular down-time and time off
Meditation and breathwork
Anti-inflammatory foods
Three meals a day without snacks
Community, love and support
Touch (for the benefits of oxytocin)
Movement and exercise to stimulate blood flow
Less sugar (to discourage the insulin-rollercoaster)
Less multi-tasking
Having animals in the home
Being in nature and in tune with seasonal and diurnal patterns
Hormone therapy where appropriate and as a personal/medical choice
Take action before you notice symptoms!

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April 2021