Menopause, Mood and Memory – What’s Normal and What’s Not

When a perimenopausal woman complains of mood swings, trouble with memory, and difficulty concentrating, the practitioner will most often be able to reassure her that these complaints are common during the menopause transition, are not necessarily progressive, and typically improve over time. However, there are other contributing factors to consider as well.

In this blog, we’ll talk about the normal symptoms associated with the menopausal transition and when further evaluation should be considered.

Menopause, Mood And Memory: What’s Happening?

Physiologically, women’s brains and bodies react to the hormone fluctuations of the menopause transition, often resulting in physical symptoms like hot flashes, mood, and memory issues. They can make women feel like they are in a constant state of PMS (premenstrual syndrome). During the reproductive years, our brains and bodies were accustomed to the hormonal levels and rhythm of the menstrual cycle. 

The fluctuations in those rhythms often result in mood and memory changes, for several years, until the hormone levels eventually stabilize to a new lower level after menopause. 

The natural timing of the menopause transition also coincides with a number of midlife stresses such as dealing with teenage children, grown children leaving home, or returning home, worries about aging parents and caregiving responsibilities, relationship issues, divorce, or widowhood, and career and financial issues.

Adding to the above, getting older in a society that values youth can be very demoralizing as women reach midlife. Many women experience issues with self-esteem and body image and also begin to contemplate their own mortality.  It is a time when many women begin to dwell on the meaning or purpose of their lives.

Menopause, Mood And Memory: What’s Normal?

Achieving optimal mental and physical health requires personalized care and solutions, but the following suggestions can help serve as a guideline to distinguish normal symptoms of menopause and signs of aging versus symptoms that may indicate a more serious medical problem

Depression

Women who have a prior history of depression (which is associated with a chemical imbalance in the brain) are at risk for recurrent depression during perimenopause. Menopause mood changes tend to wax and wane.  Symptoms of clinical depression include prolonged tiredness not relieved by rest, loss of interest in normal activities, weight gain or loss, sadness, or irritability lasting two weeks or longer. 

Anxiety

Hormone fluctuations of menopause as well as other midlife stressors can commonly result in increased anxiety, including feelings of anticipation, dread, or fear. These usually resolve without treatment. 

It is not uncommon to experience unsettling feelings just before a hot flash. Those feelings can mimic or trigger temporary feelings of anxiety. Experiencing frequent episodes of anxiety may be a sign of panic disorder. “Panic attack” symptoms include shortness of breath, chest pain, dizziness, heart palpitations, and feeling out of control. 

Memory Issues

Many perimenopausal women report difficulty focusing and mild memory problems. Many women worry that these symptoms may herald early-onset Alzheimer’s disease. Fortunately, this is rarely true. With both menopause-related memory issues and normal aging, it is very common to forget something and remember it later or forget where you placed something or an occasional word.  

Early signs of Alzheimer’s disease include forgetting recently learned information, stopping in the middle of a conversation with no idea how to continue, repeating themselves,  struggling with vocabulary, having trouble naming a familiar object or using the wrong name (e.g. calling a “watch” a “hand-clock”) forgetting important dates or events, asking for the same questions over and over, and increasingly needing to rely on memory aids (e.g., reminder notes or electronic devices) or family members for things they used to handle on their own.  

Menopause, Mood And Memory: When To Seek Help

If you feel concerned, don’t feel embarrassed about seeking help. And don’t try to diagnose and treat yourself. Recognizing a problem can lead to understanding its causes and developing good coping strategies. Your doctor can evaluate your symptoms, your personal and family history, and make expert recommendations. 

Remember, midlife is a very busy time with competing stressors. Between work obligations and caring for family, it’s very important to prioritize taking care of your needs.  Keeping balance in your life will allow you to maintain self-confidence while you meet the challenges.

Menopause Mood and Memory: Final Thoughts

Currently, it isn’t medically well understood exactly why memory and mood changes occur with perimenopause, but it appears to be related to hormonal fluctuations.

The good news is that many menopause symptoms, including mood and memory issues, are likely to be temporary. They often subside after menopause when the fluctuating hormone levels that characterize perimenopause stabilize to their new lower level.