My Journey with Cushing’s disease
At 30 years old, I was fit, healthy and naturally a size 8–10. I knew my body well, which is why, when it started to
Brain-fog and forgetfulness in perimenopause can make you afraid of an inevitable decline into dementia or Alzheimer’s (especially if a parent suffered). Disturbing headlines this past summer suggesting a link with hormone treatment may lead you to believe it will hasten your demise. Wrong! Let’s look at the evidence and help our brains stay sparky.
Up to 10 years prior to your last menstrual period your (o)estrogen (and other hormones) will decline, which may trigger vasomotor symptoms that disturb sleep and leave you feeling foggy.
You may experience “synaptic pruning” or the process of eliminating unneeded neurological pathways, leaving gaps for re-wiring.
While disconcerting to occasionally feel dim-witted, it’s temporary. Brain fog, though inconvenient, is NOT an indicator of predestined cognitive decline.
In the study that recently caused concern, Pourhadi et al. (2023) state, “Menopausal hormone therapy was positively associated with development of all causes of dementia and Alzheimer’s disease…” but goes on to say, “Further studies are warranted to determine whether these [observational] findings represent an actual effect of menopausal hormone therapy on dementia risk…”
This study is lacking in that the control group, the same as the older WHI study they cite for comparison, uses a demographic already at risk, who also primarily used oral (older) treatment, giving no distinction between micronised progesterone vs synthetic progestins, adding to possible risk factors and acknowledges possible observational bias. The study is called “unhelpful” (newsGP – Study Linking HRT With Dementia Risk ‘Unhelpful,’ n.d.), and “ doesn’t provide a conclusive answer” (Expert Reaction to Observational Study on HRT and Dementia | Science Media Centre, 2023).
The New York Times reports that the same journal where the study appears, issued an editorial, titled “A Causal Link Remains Unlikely,” (Gupta, 2023). Let’s not jump to causal conclusions. I strongly recommend reading the studies in the resources listed.
Whether or not you are able or choose not to opt for MHT, many studies show exercise alternatively or additionally can help reduce your risk for cognitive decline as well as alleviate or reduce your perimenopausal symptoms, especially those that compound “brain fog”, forgetfulness, or difficulty in concentration. Please see the exercise recommendations in our 4th issue. (Pattison, 2023)
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