Why Can’t I Remember That Word? Brain Fog & Cognitive Changes in Perimenopause

|Plainspeak Team

Q: Why can’t I remember words like I used to?

Dr. Gillian Goddard:
Our brain is replete with estrogen receptors. And in perimenopause, and even in the late reproductive stage, our estrogen looks something like this: it’s spiking and dropping and spiking and dropping.

It is actually the drop—it’s the velocity of the change—that creates a lot of symptoms because our bodies like stability.

And so those big drops in estrogen have an effect on our brain, on neurotransmission and on executive function, all of which are important for word recall.

Q: Are the cognitive changes that happen during perimenopause permanent?

Dr. Gillian Goddard:
We know that when you test women’s cognitive function serially over years—before perimenopause, during and then after—even when you give women the same tests over and over and over again in perimenopause, they don’t actually improve their scores, which we would expect them to do.

But once our estrogen levels stop fluctuating after menopause and they’re just low, we actually are able to start improving our test scores.

So it’s actually a temporary cognitive change related to this wild variation in hormones.

It’s not permanent, which I think is really important because I think a lot of times women worry that they’re developing early dementia, for example, and that is really typically not true at all.

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Dr. Gillian Goddard
Endocrinologist, adjunct assistant professor of medicine at NYU Grossman School of Medicine and author of The Hormone Loop. The best thing about midlife is no more imposter syndrome. I am confident in my expertise.

 

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