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Last updated August 28, 2016 (originally published April 20, 2010)

By Louise Carr, Associate Editor and Featured Columnist

[
Health and fitness articles are reviewed by our team of
Doctors and Registered Nurses, Certified fitness trainers and
other members of our Editorial Board
.]






You’ve heard about the hot flashes, fatigue, lower sex drive,
and irregular periods in perimenopause, but did you know
that going through perimenopause can also affect your
brain? If the physical symptoms of this challenging time aren’
t enough, it appears perimenopause also impacts your
cognition, memory, and mood.

How are perimenopause symptoms linked to your brain?
What are the most likely brain effects of perimenopause on
women?

What is Perimenopause?

Perimenopause literally means "around menopause".

The term perimenopause refers to the period of time where
a woman is making the transition towards menopause, which
means permanent infertility.

Perimenopause is also called progression towards
menopause, or menopausal transition.

Perimenopause starts at different ages for different women.
You may notice signs of perimenopause like irregular periods
in your 40s, or earlier in your 30s.

The average time to be in perimenopause varies, too, and
can last up to four years. Once you have been through 12
months consecutively without a period, you are officially in
menopause.

Perimenopause brings a variety of physical symptoms, and it
also affects certain ways in which your brain works.

Mood and Brain Changes During Perimenopause

Is perimenopause brain fog a real thing?

As well as the physical changes associated with the
perimenopausal time, scientists are increasingly sure that the
perimenopause signals changes in mood, and in cognition.
The Seattle Midlife Women’s Health Study (2001) showed
that out of 230 women interviewed aged between 33 and
55, 60 percent had noticed an unfavorable change in
memory over the past few years.

Women reported problems with recalling numbers and
words, difficulty remembering appointments, difficulty
concentrating, losing household items, and having to use
memory aids.

The Study of Women’s Health Across the Nation (SWAN) in
2000 also reported a link between perimenopause and
forgetfulness. In the survey of 12,425 women aged 40 to 55
years, 44 percent of perimenopausal women said they were
more forgetful than normal.

In addition to memory loss, some women experience
increased risk of depression and anxiety, plus mood swings
and irritability.

Mood changes and changes in cognition could be linked to
sleep disruption and the symptom of hot flashes, or they
could be caused by hormonal changes not related to these
symptoms, doctors say.

What are the key ways in which scientists think
perimenopause affects the brain? We looked at recent
scientific studies to find out.


























1.
Perimenopause Could Increase the Risk of Developing
Neurodegenerative Diseases


Perimenopause is a neurological transition state, according
to experts.

Although it has primarily been viewed as a reproductive
transition, the symptoms of perimenopause are largely
neurological in nature, according to the authors of a 2015
study at the University of Southern California in Los Angeles.

The neurological symptoms that emerge are caused by a
disruption in the supply and flow of estrogen around the
body, and as a result of estrogen disruption, neurological
dysfunction can develop.

This, according to the authors of the study, can increase the
risk of developing neurodegenerative diseases later in life.
Scientists see the perimenopause as a crucial period where
there is a window of opportunity to prevent these age-
related neurological diseases from developing.

2.
Perimenopause Affects Levels of Verbal Fluency

The Kinmen Women-Health Investigation (KIWI) in 2006
looked at 694 Chinese residents living in Kinman, Taiwan
who had an average age of 46 years.

Participants were tested on verbal memory, verbal fluency,
processing speed, and mental flexibility and tested again
after 18 months.

Performance on all the tests improved, as would be expected
due to learning effects, but the women who transitioned to
perimenopause during the 18 months showed statistically
less improvement in verbal fluency than those women who
did not transition into perimenopause.

3.
Perimenopause Makes You More Vulnerable to Depression

Perimenopause is a time of increased risk of depressive
symptoms and depressive disorders, according to experts.

A 2014 study by the University of Rochester looks at how
declines in estrogen in the perimenopausal period are linked
not only to declines in cognitive functioning but to an
increased risk of depressive disorders.

In the study perimenopausal and post-menopausal women
were at significantly increased risk of depression, compared
to premenopausal women.

4.
Perimenopause Changes Your Mood?

Estrogen’s effects on serotonin, and the changing levels of
estrogen in perimenopause, could be behind the effect of
perimenopause on mood.

A 2006 study from Yale University School of Medicine shows
that after a serotonin-depletion procedure, 19 women with a
mean age of 52 years experienced a decrease in verbal
memory, but that estrogen therapy buffered this effect –
meaning that estrogen seems to have an effect on cognition,
and it also positively affected mood in the experiment.

Estrogen was also found to modulate mood and cognitive
performance in a 2003 study from Yale University, which
examined the effects of estrogen supplementation on
serotonin systems and cognitive function in 10 women aged
around 54 years.

5.
Perimenopause is Linked to an Increased Anxiety Risk

Anxiety may occur at any stage in a woman’s life but it
seems that panic and anxiety attacks are more common
during the perimenopausal period.

There is a connection between the hormonal changes in
perimenopause and psychiatric disorders in general, and in
particular depression and anxiety.

A 2010 study from The Reading Hospital and Medical Center,
Pennsylvania showed a high prevalence of women with
anxiety in an inner city menopause clinic.

6.
Do Hot Flashes Cause Memory Problems in
Perimenopause?


Women often blame hot flashes for cognitive problems like
memory loss and mood changes, as hot flashes relate to lack
of sleep, stress, and disruptive physical symptoms. But many
investigations into the subject find no link between hot
flashes and cognitive problems, suggesting that cognitive
problems are linked instead to other hormonal changes.
However, a 2008 study from the University of Illinois did find
that objectively observed hot flashes were linked to decline
in verbal memory, leaving the possibility that hot flashes
contribute to memory loss open.

7.
Higher Cortisol Levels in Perimenopause Linked to
Cognitive Performance


One way in which hot flashes may be linked to depressive
symptoms and decline in memory is through cortisol levels.
Cortisol levels increase after a hot flash, according to
authors Meldrum DR, Defazio JD, Erlik Y, et al in 1984, and
higher cortisol levels are linked to an increased risk of
depressive symptoms as well as poorer performance on
memory tasks.  










































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