AYou may already know that menopause has a lot of fun symptoms, to put it mildly. Mostly, people talk about hot flashes and mood swings. But new research shows that perimenopausal and menopausal people also experience brain fog, anxiety, and depression at an astonishing rate, despite the relative lack of discussion surrounding them. And is that this information gap makes the “change” even more disconcerting, says Alicia Jackson, PhD, health technology entrepreneur and founder of Evernow, a direct menopause treatment business to the consumer.
“There are a lot of women who come to us like,‘ My doctors don’t do anything for me. ’And sometimes,‘ I didn’t even realize I was going through menopause because it wasn’t the symptoms I was looking for, ’” says the doctor. Jackson. “So many women are told, ‘Oh, maybe you should eat better, exercise, or try to have less stress in your life.’ And it’s like you’re actually going through perimenopause and you can do something about it.”
“Menopause has been misunderstood.” —Alicia Jackson, doctor, founder of Evernow
In a study that included more than 40,000 perimenopausal and menopausal women, Evernow found that nearly 80% of respondents experienced brain fog and 60% reported anxiety and depression. (The research did not shed light on findings between non-binary or transgender individuals with uterus.)
“Overall, the story we’re seeing is that mood problems increase at perimenopause and then slowly decrease,” says Catherine Hansen, MD, MPH, Evernow’s medical consultant and OB / GYN. “Interestingly, brain fog is a real issue that does not seem to improve. As for why we see these effects on mental health and mood, it is known that hormones such as estrogen bind to receptors on the same brain cells, providing stabilization and modulating other chemical messengers such as the neurotransmitters acetylcholine, serotonin, dopamine and GABA “.
More than mood swings
It is the decrease in estrogen that causes the symptoms of cognitive and mental health of menopause, says Dr. Hansen. Specifically, two brain areas, the pre-frontal cortex and the hippocampus, known for high-level cognitive function, learning, and memory, are rich in estrogen receptors and appear to be affected by a decrease in estrogen, ”he says.
When these changes occur, they can have an impact on mental health and well-being, says Makeba Williams, MD, Evernow Women’s Health Advisor and OB / GYN. “Significant decreases in the ability to remember, learn, or make quick decisions about the timing of perimenopause and menopause can cause immense frustration that causes anxiety, increased stress, and sleep disorders,” says Dr. Williams. “It is also worth mentioning that the menopausal transition often occurs in periods of maximum stress, as women often have the responsibilities of children (adolescents / adults) and aging parents, and perhaps increase occupational stress and change. These family and work-related challenges, along with other stressors, can exacerbate these symptoms. “
Something that can make the problem worse? Dr. Jackson says that perimenopausal and menopausal people do not usually know the symptoms of doctors because many doctors are not even aware of them. Similar to other reproductive health problems, such as uterine fibroids, menopause is poorly funded and poorly researched.
“Most doctors have only received one or two hours of training on menopause,” she says. “And when they’re told about it in the traditional sense, they’re told it’s choking and night sweats.” And it’s not much better among OB / GYNs, only one in five gynecologists is trained in menopause. “It simply came to our notice then [than other doctors], but they are far behind. Because traditionally, OBs try to give birth to babies and gynecology was about gynecological surgery. Therefore, hysterectomies were how you often treated female problems. Menopause has been misunderstood.
Some key findings from Evernow’s research
Among the main revelations of Evernow’s study was that weight did not affect menopausal symptoms, as is conventionally accepted. “Heavier women are traditionally believed to have milder menopausal symptoms because fat produces a form of estrogen,” says Dr. Jackson. “However, we found the exact opposite, which is that heavier women tend to have worse menopausal symptoms.” In addition, they found that women who have had hysterectomies experience worse menopausal symptoms than those who entered menopause more gradually.
“We found that women who had hysterectomies had significantly worse symptoms than women who didn’t,” says Dr. Jackson. “Women need to be prepared for this; they need to be educated about it. It has to be said, “Okay, this may be the best thing to do, but if that happens to you, you’ll probably also want to consider hormone therapy to supplement the fact that you’re going from 100 to zero overnight.”
While diet, exercise, speech therapy, mindfulness, and antidepressants can help menopausal mental and cognitive health symptoms, Cynthia Krause, MD, Evernow Women’s Health Advisor and OB / GYN, says hormone therapy can also be very beneficial. “It can increase a woman’s estrogen levels,” she says.
Evernow currently collects follow-up data from more than 250 of its members on how they improved their symptoms after starting hormone therapy. So far, more than 63% saw an improvement in brain fog, 78% found an improvement in anxiety and depression, and 76% saw an improvement in mood swings.
Hormones that are used to treat menopausal symptoms usually have much lower doses than birth control hormones, which is often the only hormone treatment option that perimenopausal people receive from their doctors.
“Low-dose birth control that combines estrogen and progestin may also work well for perimenopausal symptoms,” says Dr. Krause. “A disadvantage is that many women in the perimenopausal age group have contraindications for hormonal birth control due to underlying medical conditions or smoking. It is a higher dose than we give for menopause because its purpose is to provide contraception “. In addition, unlike birth control, the estrogen patch we use most often does not increase the risk of blood clots.
Beginning of hormone therapy for menopause
When you want to start hormone therapy for menopause, the first step is a conversation with your doctor. “The doctor is really there as someone you hire to help you take care of your body and it’s there to help you give you the options that will be safest and most effective for you,” Dr. Jackson says. If you have any questions, we advise you to defend your case and know that you have the right to do so. However, if your doctor is unwilling or unable to provide you with the menopausal care you are interested in, you may want to consider finding a doctor who is menopausal or try a service like Evernow that you can use with your doctor. .
“If your doctor isn’t up to date on the things they’re trying to control, this will never be good for your overall health,” said Stephanie Faubion, MD, medical director and medical director of the North American Menopause Society ( NAMS) At the Clinical Center for Women’s Health, she already told Well + Good If you think you’re not getting the answers you need, Dr. Faubion says you should see someone else.
Even without hormone therapy, some of the symptoms of menopause will improve on their own, meaning you can get rid of these hormones without experiencing a relapse of symptoms. “Menopausal symptoms usually decrease over time, but studies have shown that they last an average of seven years, longer than we thought before,” says Dr. Krause. “In addition, about 10 percent of women continue to experience menopausal symptoms indefinitely.” Although the incidence of brain fog remains high between perimenopause and late menopause (five to ten years after the last period), anxiety and depression decreased from 67% to 55% and changes in mood decreased from 71% to 48%, Evernow’s research shows.
And while this Evernow study is a big step in the right direction, much more research needs to be done about menopause and its treatment options. “The media is finally starting to focus more on this demographic information and the hope is that this will also raise awareness in the scientific community,” says Dr. Krause. “One of the reasons we felt it was so important to publish the study was to provide more information about this experience in the hopes of generating more interest among all parties. The impetus sets in motion.”
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