Menopause Symptoms and Memory Loss

While you may experience the misery of hot flashes and mood swings as you
enter menopause, one thing you can't blame on the "change" is memory loss.

In the latest study that exonerates menopause as a cause of impairing the
ability to recall, Taiwanese researchers compared the memory of hundreds of
women before they had any menopausal symptoms to their memory as they
entered menopause.

They found the women who were going through the menopausal process scored as
well or nearly as well on five different cognitive function tests. Results
of the study are to be presented Oct. 4 at the American Neurological
Association annual meeting in Toronto.

"When women go into perimenopause, they don't need to worry about cognitive
decline," said Dr. Jong-Ling Fuh, an attending physician at Taipei Veterans
General Hospital and an associate professor of Yang-Ming University School
of Medicine.

The researchers said the myth of memory loss during menopause is a
perception some women have because as they went through menopause, they felt
their memory wasn't as sharp as it had been before. Studies suggesting that
hormone replacement therapy might protect against dementia strengthened that
belief. However, a large study later found that in older women, hormone
replacement therapy not only didn't help protect women from dementia, but
could actually increase the risk.

To try to answer the question of whether menopause did have any effect on
memory, Fuh and her colleagues studied nearly 700 premenopausal women living
on a group of rural islands between Taiwan and China. The Taiwanese
government restricted access to these islands until the 1990s, so the
authors report that the study's population was nearly homogeneous, which
would help rule out other potentially causative factors of memory loss.

The women were between the ages of 40 and 54. None of them had had a
hysterectomy, and none took hormone replacement therapy during the study.

All took five cognitive tests designed to assess their memory and cognitive
skills at the start of the study, and then again 18 months later.

During the study period, 23 percent of the women began to have symptoms of
menopause.

The researchers then compared the memory of the women who had entered
menopause to those who had not, and found very little difference. In four of
the five tests, there were no statistically significant differences in the
two groups of women.

Only on one test was the difference statistically significant, and that
difference, said Fuh, was very slight. This test was designed to assess
verbal memory and involved showing the women 70 nonsensical figures. Some of
the figures were repeated during the test, while most were not. The women
were asked whether they had seen the figure earlier.

"For women, menopause does not mean you'll develop memory loss," said Dr.
Raina Ernstoff, an attending neurologist at William Beaumont Hospital in
Royal Oak, Mich. As you're going through perimenopause and experiencing
symptoms like hot flashes, she said, you may feel lousy and have trouble
sleeping, which might temporarily affect your cognitive skills.

"I don't think declining estrogen levels are what causes memory loss," said
Dr. Steven Goldstein, an obstetrician/gynecologist at New York University
Medical Center in New York City. "It's not like your memory is bopping
along, doing fine and then takes this big dive during menopause, like bone
density can."

Both Ernstoff and Goldstein said they weren't aware of many women who
believed that menopause might cause significant memory loss. They also both
felt that results from this group of women who were so homogeneous might not
apply to different groups of women, such as those living in more
industrialized society. And they both said that other factors that weren't
studied could play a role in memory loss, such as hypertension, which can
contribute to vascular dementia.

Ernstoff also pointed out that the education backgrounds can play a large
role in memory loss. Fuh acknowledged the researchers did attempt to control
the data for educational differences.

SOURCES: Jong-Ling Fuh, M.D., attending physician, Taipei Veterans General
Hospital, and associate professor, Yang-Ming University School of Medicine,
Taipei, Taiwan; Steven Goldstein, M.D., obstetrician/gynecologist, New York
University Medical Center, and professor, obstetrics/gynecology, New York
University School of Medicine, New York City; Raina Ernstoff, M.D.,
attending neurologist, William Beaumont Hospital, Royal Oak, Mich., and
member, Alzheimer's Board of Detroit; Oct. 4, 2004, presentation, American
Neurological Association, Toronto.

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