If you’re feeling more scatterbrained than before or that your brain feels woolly, you may wonder if there’s something seriously wrong
• Brain fog is a common symptom of perimenopause and menopause
• Women are more likely to have dementia than men
• How to tell the difference between brain fog and dementia
If you’ve become increasingly forgetful, have misplaced items or put them in the wrong place, can’t remember people’s names, have struggled with making decisions or focusing, or lost interest in activities you used to love, you may have started to worry that something is wrong with your brain. After all, these are all recognised symptoms of dementia. But they are all also symptoms of brain fog, which is an incredibly common symptom of perimenopause and menopause.
So how can you tell the difference? This article will explore the symptoms of dementia and menopausal brain fog more fully, to help you determine what support and treatment you might need.
What is dementia?
Dementia is an umbrella term for a range of conditions that affect the brain, the most common of which are Alzheimer's disease, vascular dementia and frontotemporal dementia. According to the World Health Organisation, 57 million people had dementia worldwide, and every year, there are nearly 10 million new cases.
Dementia is more prevalent in women than in men and globally is the commonest cause of death in women.
Dementia causes changes in memory, thinking, personality and behaviour, but just as there are different types of dementia, there are also different symptoms.
What is brain fog?
Brain fog isn’t a medical term, but it describes moments where your brain might feel like cotton wool, you’re forgetful, you might lose your keys, write endless to-do lists, and find it hard to retain information. This can make it especially hard to function at work, and you might struggle to concentrate when reading or watching TV.
Brain fog is very common during perimenopause and menopause – in fact, in a Newson Health survey of almost 6,000 women, 90% said they were affected by it, making it the most common symptom [1].
These symptoms can be so severe that you may start to worry that you have dementia, and it can be particularly concerning if you have a family history of dementia.
RELATED: Hormones and brain health
How do hormones affect your brain?
The hormones oestradiol, progesterone and testosterone play many important roles in cognition and memory. When levels of these hormones fluctuate and fall during perimenopause and menopause, this can lead to a range of cognitive symptoms, including memory loss, difficulty staying focused, word-¬finding difficulties, losing your train of thought and becoming confused easily.
These hormones stimulate your brain, keep your neurons (nerve cells) firing, support the growth of new cells and help existing cells to form new connections. When hormone levels fall, your entire body – including your brain – goes into a sudden deprivation state. At a cellular level, these hormones help your brain cells to burn more glucose, which is its main fuel. Studies have shown that there is an overall reduction of brain energy levels during perimenopause and menopause, which can trigger hot flushes, night sweats, anxiety, depression, brain fog, and other cognitive symptoms.
Testosterone strengthens nerves in your brain, and contributes to mental sharpness and clarity, as well as overall energy levels.
These hormones also work on the cardiovascular system to improve blood flow to your brain, which is important for your brain to function well and to reduce memory loss.
RELATED: Menopause and brain health: what's the link?
Why do more women suffer from dementia?
Two thirds of people globally with Alzheimer’s are women, and women are diagnosed later than men and decline faster. Dr Lisa Mosconi’s studies of women’s brains has led her to believe that Alzheimer’s isn’t a disease of old age – it’s one of midlife but symptoms can take years to show up.
It has been known for decades that menopausal women have an increased risk of developing Alzheimer’s – these hormones are neuro-protective. Research has shown that the longer a woman is menopausal (ie with low hormone levels), the greater the future risk of developing dementia. This means also that women with POI (premature ovarian insufficiency) who are menopausal under the age of 40 have a greater risk of dementia (if they do not take hormones) compared to older menopausal women.
RELATED: The role of hormones in our brain and nervous system
Will I get dementia like my mum/dad?
Many women worry that they may be at greater risk of developing Alzheimer’s or other forms of dementia because a relative had it. The average lifetime risk of developing dementia is 10%–12% and increases to 15%–25% for individuals with a family history of dementia [2].
If you have a family history of dementia, there are several modifiable risk factors, including hypertension, high cholesterol, diabetes mellitus, CVDs, obesity, being overweight and depression [3]. Research has suggested that people whose parent had dementia might benefit from dementia risk reduction, which can involve looking at your lifestyle and overall health. This is because a combination of genes, health, environment and lifestyle can affect your risk of developing dementia.
How do I know if I have brain fog or dementia?
There is no test to distinguish between the two. If you are perimenopausal or menopausal with brain fog then taking the right dose and type of HRT, often with testosterone, will usually improve your memory and brain fog.
People with dementia may also experience personality changes and withdraw socially. Dementia symptoms are also progressive – they will get worse over time rather than come and go.
It is often hard to distinguish between the two so it is important to consult with a doctor who understands hormones and brain health.
How can I look after my brain?
There are things you can do to support your brain health – lifestyle changes and HRT, often with testosterone, can often improve brain fog symptoms.
A healthy diet, regular exercise and deep sleep can improve and maintain brain health. The right type and dose of HRT, often with testosterone, can usually improve brain fog and help you think more clearly. Many women find that their energy and motivation to exercise increases when they start taking HRT and that their quality of their sleep improves. You can find more tips in our article How to beat menopausal brain fog.
RELATED: The menopause brain: why it might be feeling strange and what you can do about it
