“Doctor, I’m Forgetting Words…”
She sat across from me, eyes brimming with worry:
“I’m forgetting words—names I’ve known forever. I walk into a room and forget why I’m there. I’m scared… What if this is Alzheimer’s?”
She’s not alone. Bright, capable, successful women—often in their 40s or 50s—come to me with similar concerns. They’re not just tired. They’re frightened. And too often, they’re asking the wrong question.
Is it Alzheimer’s… or is it menopause?
Dr. Emma Pollon-MacLeod discusses the role of hormones in women’s cognitive health in this engaging webinar, in partnership with The Memory Clinic’s Thursday Chats webinar series.
The Overlooked Connection Between Hormones and the Brain
Menopause is more than just the end of your period. It’s a neuroendocrine transition, a profound shift in how the brain and body communicate. As estrogen and progesterone levels swing and eventually decline, the brain feels it.
What’s Actually Happening in the Body?
From birth, women have a finite number of follicles (eggs) in their ovaries. These follicles produce estrogen and progesterone, hormones that support everything from your cycle to your cognition.
As menopause approaches:
- Follicles decrease in number and responsiveness.
- The brain tries harder to stimulate them, often resulting in wild hormone fluctuations.
- This causes a breakdown in the normal feedback loop between the brain and ovaries.
The result? Mood swings, hot flashes, heart palpitations, and yes, brain fog, forgetfulness, and anxiety.
Cognitive Changes in Midlife: What’s Normal?
Over 50% of women going through menopause report cognitive difficulties like:
- Trouble focusing
- Memory lapses
- Slower processing
- Struggles with multitasking
These changes are usually temporary. The brain adapts. Most women return to baseline cognitive function after menopause. But support during this transition is crucial, not only to ease symptoms but to build long-term brain resilience.
When Should You Be Concerned?
Menopause can mimic early Alzheimer’s symptoms, but there are differences:
- Menopausal cognitive changes are usually temporary and reversible.
- Alzheimer’s causes progressive, irreversible cognitive decline.
You should seek further evaluation if:
- Symptoms persist more than 5–6 years post-menopause
- You have a family history of Alzheimer’s
- You carry the ApoE4 gene
Women are already at higher risk of Alzheimer’s. That’s why early prevention and support during menopause matter.
How to Support Your Brain During Menopause
The best way to maintain mental sharpness? A comprehensive approach to health.
1. Move Your Body
Regular physical activity improves brain blood flow, reduces anxiety, and supports memory.
- Aim for 30 minutes of movement most days—walks, yoga, strength training.
2. Feed Your Brain
- Eat a Mediterranean-style diet:
- Leafy greens, berries, colourful veggies
- Healthy fats from fish, nuts, olive oil
- Whole grains and lean proteins
- Limit sugar, alcohol, and processed foods to stabilize blood sugar and mood.
3. Monitor Your Blood Pressure
High blood pressure in midlife is linked to later-life cognitive decline.
- Check your BP regularly
- Watch sodium intake and consider magnesium supplementation
- Follow treatment if prescribed
4. Nourish with Nutrients
- Omega-3s: Especially DHA-rich sources like fish oil (1–2g/day)
- B Vitamins (B6, B12, Folate): Key for memory, methylation, and mood
- Vitamin D: Supports cognition and mood (get your levels checked!)
- Magnesium: Helps calm the nervous system and supports sleep
5. Consider Menopause Hormone Therapy (MHT)
MHT can support cognitive health, especially when started early in the transition, before the brain adapts to estrogen loss.
- Transdermal estradiol + micronized progesterone preferred
- Not recommended for dementia prevention alone
- Not suitable for everyone; work with a qualified practitioner
The Takeaway: Progress, Not Perfection
You don’t have to do everything at once. Start with one small change today:
- Take a walk
- Add leafy greens to dinner
- Get your vitamin D tested
- Talk to your doctor about hormone therapy if you’re in perimenopause
Menopause is a transition, not a decline. With the right support, you can feel clear, confident, and capable again. Cognitive changes during menopause are real, but they’re not a life sentence. They’re a signal from your body that it’s time to listen, adapt, and care for your brain in new ways. If you’re experiencing brain fog, forgetfulness, or mental fatigue, know that you’re not alone, and there are tools to help you thrive through this stage and beyond.
Need support? Book a consultation with a naturopathic doctor to create a personalized plan that works for you.
