Why Am I So Forgetful?Menopause and Brain Fog

You’ve read the same email three times. The word for the thing in your hand is gone, and you’re calling it “the whatsit.” Your phone is in your other hand.

What the big study found

The Study of Women’s Health Across the Nation (SWAN) followed 2,362 women for 4 years. A 2009 study in Neurology¹ used it to test three kinds of thinking: processing speed, verbal memory and working memory.

The pattern was subtle. Women who were premenopausal and postmenopausal got better with repeated testing, which is normal, since you learn the test. Women in late perimenopause did not improve, and neither did women in early perimenopause on verbal memory.

Then performance rebounded to premenopausal levels in postmenopause. The researchers concluded that the cognitive difficulties tied to the menopause transition may be time-limited.

So the dip is a stall, not a slide, and it’s linked to the stage you’re in.

What it feels like, and how it was counted

The National Institute on Aging (NIA)² lists forgetfulness and difficulty concentrating among the symptoms of the menopausal transition, along with moodiness and irritability, and says you may notice memory problems or trouble focusing.

A 2010 analysis in the American Journal of Epidemiology³ says a majority of women report memory problems around menopause, though the studies that measured performance gave mixed results. Of the three it reviewed, two corroborated the complaints and one found processing speed and working memory unaffected by the transition.

So if you feel off, you’re in good company. The tests agree with each other less than the feeling does.

Mood, sleep and hot flashes

The same 2010 analysis checked what else may explain the fog. Women with high levels of depressive symptoms scored about 1 point lower on a processing speed test, a small effect. High anxiety slowed learning on verbal memory tests. But the study found no detrimental effect of sleep disturbance, and no relation between hot flashes and cognitive performance.

It’s worth holding that next to the NIA’s⁴ list. The NIA includes sleep problems, depression, anxiety, thyroid, kidney or liver problems, medication side effects, alcohol misuse, and low levels of nutrients such as vitamin B12 among the factors that can cause memory problems. Memory trouble from medical conditions usually goes away once the condition is treated, the NIA says.

The honest summary is that the evidence is mixed, and the list of things to check is long.

What helps on an ordinary day

The NIA’s⁴ tips for forgetfulness are plain. Follow a daily routine. Plan tasks, and use calendars, notes and to-do lists. Keep your wallet, keys, phone and glasses in the same place every day. Learn a new skill, and stay involved with friends, family and your community.

For the body: get enough sleep, usually seven to eight hours a night, exercise and eat well, control high blood pressure, and avoid or limit alcohol. If you feel depressed for weeks at a time, get help.

One more thing from the NIA⁴: be cautious of pills, supplements and brain-training games that promise to improve memory. They may be unsafe, a waste of money, or both, and the NIA says to consult your doctor before buying any.

The play

Try this: keep a fog log

When you blank on something, jot down the date and what it was.

Add how you slept, your mood, and if you had hot flashes that day.

Bring the page to your appointment. It turns “I’m forgetful” into a pattern a clinician can read.

When to get checked

The NIA⁴ says to talk with a doctor about noticeable changes in your memory. Signs that it may be time include asking the same questions over and over, getting lost in places you used to know well, having trouble following recipes or directions, becoming more confused about time, people and places, and not taking care of yourself. A doctor can run tests to find the source.

If stress-related memory trouble persists after a few weeks, the NIA⁴ says to see your doctor, because it may be a sign of something more serious. It also says forgetfulness can be a normal part of aging, and dementia is not.

Book an appointment if any of these fit:

• You ask the same questions again and again
• You get lost somewhere familiar
• Familiar tasks, like following a recipe, have become hard
• The fog is getting worse rather than staying the same
• You’ve felt low or anxious for weeks

Most days the word comes back. When it keeps not coming back, that’s the appointment.