I turned 50 this year and in the last two years have been constantly struggling to find the right word or name for things and people. I have a really busy, demanding job but have started to lose my confidence completely which is affecting my work.

My family will sometimes find it funny if I can’t find the right word for something but it really upsets me.

I have to write everything down or I will forget it… I feel constantly anxious about this and am terrified that I am experiencing early dementia. I’m so embarrassed, what is going on? Cognitive changes affect 80% of women.

Dr. Caoimhe Hartley response:

Cognitive changes affect 80% of women. They tend to be worse for women who have more severe hot flushes/ night sweats, disturbed sleep, and women who have had surgical menopause. We have estrogen receptors throughout our brains.

Estrogen is a regulator of energy use in our brains and plays a role in how we protect our brains from damage. Let me be straight- treating “brain fog” is hard. It is a difficult symptom to pin down.

It does not reliably respond to estrogen/ HRT. It can be horribly distressing and can destroy your confidence. There is a lack of research in this area so there are a lot of ‘unknowns’ but I will tell you what we do know.

1. Traditionally women outperform men on memory tasks but as estrogen falls, we lose this advantage.

2. Cognitive changes are not in your head.

They are a real, demonstrable symptom of hormonal change. Changes in how our brains function can be seen on brain imaging/scans and are independent of ageing (we see similar changes in the brains of women who have their ovaries removed in their twenties and thirties).

3. These changes in verbal fluency and memory are TEMPORARY. For the majority of women, with time, these symptoms will improve and resolve.

4. HRT may (or may not) improve cognition. Lots of unanswered questions here. But getting better sleep, reducing alcohol, and increasing exercise will help.

Dr. Caoimhe Hartley is a GP and Women’s Health specialist who runs a dedicated menopause clinic, Menopause Health, in Dalkey, Co Dublin. She is also the Clinical Lead of the Menopause Service in the Rotunda Hospital.

Dr Caoimhe Hartley will speak at the National Menopause Summit which takes place in The Round Room at The Mansion House in Dublin’s city centre on Thursday, March 23, 2023. Tickets, speaker line-up and event details available at: nationalmenopausesummit.com.

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