Dear doctor: I am 52 years old and I am going through menopause. I used to know insomnia, night sweats and hot flashes, which are talked about a lot. What is upsetting is that I am also becoming mentally less lively than before. Is it also part of menopause? Would hormone replacement therapy help?

Dear reader: Menopause, like pregnancy and childbirth, is one of the major stages in a woman’s life. Yet women often face menopause on their own, compared to the abundance of books, classes, and doctor’s visits that help them prepare for a baby. This leaves many women unaware of when symptoms start and what form they may take.

A woman goes through menopause when she has gone 12 full months without a period. The transition to menopause, known as perimenopause, is often slow and gradual. It occurs due to a natural decline in reproductive hormones when a woman’s ovaries stop working.

Symptoms include trouble sleeping, night sweats, and hot flashes that you mentioned. They can also include cramps, headaches, weight gain, fatigue, sore breasts, thinning hair, low libido, urinary incontinence, depression, anxiety, and others. mood changes.

And yes, the memory changes you experience often accompany menopause as well. In fact, it is estimated that up to two-thirds of women may have some degree of cognitive impairment associated with menopause. Commonly referred to as brain fog, it can be marked by problems with making decisions, learning and retaining new information, concentrating and thinking clearly, and increased forgetfulness.

While the reasons for menopause-related cognitive impairment are not entirely clear, research suggests a link to the decline in reproductive hormones, especially estrogen. Sleep disturbances are also thought to play a role.

Hormone replacement therapy, which involves either low-dose estrogen or a combination of estrogen and progesterone, is sometimes prescribed to relieve the physical symptoms of menopause. Some women say it helps with cognitive issues as well. However, it is important to note that long-term use of HRT is associated with adverse health effects, including an increased risk of breast cancer, heart attack, stroke, and blood clots in the breasts. legs and lungs.

Talk with your health care provider to find out if the benefits of HRT outweigh the risks in your particular situation. Lifestyle changes can make all the difference, starting with a healthy, balanced diet. Consider taking the Mediterranean diet seriously, which is high in brain-boosting omega-3 fatty acids and unsaturated fats, and is also good for the heart. Eating a wide variety of fresh fruits, vegetables, and leafy greens has been repeatedly linked to improved cognition.

Exercise is also helpful. Recent studies have shown that even light exercise, such as a yoga or tai chi class, or a low-intensity session on a stationary bike, can improve both memory and mood. Quality sleep is important for cognition, so take good sleep hygiene seriously. The good news is that for most postmenopausal women, these cognitive changes don’t last. However, if the symptoms worsen, you are encouraged to consult your health care provider to rule out other causes.