Research shows that women transitioning through menopause (i.e. from 2 years before the final menstrual period till 2 years after that), are more likely to experience cognitive changes and depressive symptoms compared to pre-menopause days.
For example, many women commonly complain of the following cognitive changes around the time of menopause:
Less able to focus/ concentrate
Changes in mood in particular low moods, as well as irritability, anger outbursts and emotional lability are also commonly experienced. Other typical symptoms include reduced sexual interest, sleep disturbance as well as physical symptoms such as increasing pain and an increase in weight.
Do You Find Yourself Becoming More Forgetful?
The cognitive changes experienced during the menopause transition are mostly verbal memory loss, which is the ability to process information presented in the verbal form. This could mean forgetting things that were shared through chats with your family and loved ones, or being less able to remember lists, names or things told to you in a story. Interestingly, this type of memory is where women traditionally out-perform men at any age.
Are You Experiencing Changes in Moods?
Women in perimenopause are twice as likely as women pre-menopause to experience depressive symptoms, even though it may not necessarily be severe enough to be classified as a major depressive episode. In addition, women with a history of a previous major depressive episode have an almost 60% chance of experiencing that recurrence during the menopause transition.
The risk of having depressive symptoms and/or a major depressive episode increases with a stressful environment. Unfortunately, the menopause transition often coincides with more socially stressful events such as dealing with an empty nest, marital discord and sick parents.
Depressive symptoms are slightly different during menopause, with these women experiencing less sadness and more anger, irritability and paranoid symptoms. These symptoms can also have a very quick onset and just as quickly blow over. This often causes distress to women and can also significantly impact their close relationships.
A scale has been developed in research, called the Meno-D rating scale, for grading the severity of depressive symptoms in women going through the menopause transition.
Why Do These Changes Happen During Menopause?
Both cognitive and depressive symptoms are thought to be related to changes in hormone levels as a woman goes through the menopause transition, in particular a decline in estrogen levels.
Estrogen has been shown to have a role in neuronal health, such as keeping brain inflammation levels low and increasing neuronal growth. Estrogen is also involved in moderating the activity of neural chemicals in the brain such as serotonin and dopamine, hence its importance in mood regulation.
Do These Changes Disappear After Menopause Ends?
The cognitive changes appear to be temporary and verbal memory has been shown to improve after the menopause transition. Hormone replacement therapy has also been shown to improve cognitive function. Hormone replacement therapy in patients with long-term usage have been shown to reduce the likelihood of dying from Alzheimer’s disease by 26%.
Patients with a major depressive episode during menopause transition should still consider seeing a psychiatrist and consider antidepressant therapy, although there is some evidence that depression and depressive symptoms in the menopause transition may respond differently to antidepressants. Both hormone replacement therapy and cognitive behavioural therapy have been shown to improve depressive symptoms in this group of women.