A-Z

Menopause

Memory, concentration and the menopause

Changes in hormonal levels during the menopause, the ageing process and social factors at midlife can all impair memory and concentration. Coping with symptoms alongside the stress of work and domestic responsibilities can be exhausting and confusing (see ‘Work’ and ‘Family, health and life events’). Women told us how problems with memory and concentration affected them and how they coped.

 

Margaret is unsure whether her poor memory was caused by the stress of her parents’ death, ‘a...

Margaret is unsure whether her poor memory was caused by the stress of her parents’ death, ‘a...

Age at interview: 59
Sex: Female
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My memory. Was absolutely, I’ve always had a good memory. I’ve been able to remember phone numbers, names, addresses, all kinds of, just the information of daily life. And I couldn’t remember words. I couldn’t remember where I was supposed to be. I had to start writing everything down. I thought it was stress. I thought it was because of losing mum and dad and that, that it would come back.

And in fact it has come back a bit better but that’s mainly because I’ve been studying so I’ve been making myself remember stuff because I’ve been having to take three hour exams and things. Really had to concentrate. And now I’m approaching 60 and it is better but I said to my husband the other day, “I’m really worried about the fact that I start a sentence and I can’t remember what I was going to say.” And that I find really quite worrying and whether that is a hormonal thing or whether that is a result of coming off the HRT I really don’t know or whether it’s the beginning of something to do with getting much older. I don’t know.

Effects of poor memory and concentration
Forgetting words, appointments, keys, people’s names and birthdays, or doing ‘silly things’ like filling the bath up with cold water are frustrating. Women felt disconnected and a ‘little bit out of town’ when they couldn’t remember even simple everyday things. They talked about their memory being ‘shot to pieces’, about their brain being ‘in a vacuum’, of having a ‘huge hangover’ and ‘cotton wool for a brain’.
 

Dr Sally Hope talks about the problems some of her menopausal patients have with memory

Dr Sally Hope talks about the problems some of her menopausal patients have with memory

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Because I work in Oxfordshire, I have a group of very brilliant academic women as patients and they are much more worried about the mental side effects of the menopause. They actually don’t care so much what they look like or whether they’re having hot flushes but they really care that they can’t remember a reference to a mediaeval history paper that they knew just like that or the numbers of their children’s mobile phones any more or their own telephone number. And we do know that there is some short term memory difficulties as you’re going through the menopause that appear to get better, hopefully, after the menopause. And it’s not clear, I mean there are some tests showing that oestrogen does actually help your mental function at this point. Also, because you’re having hot flushes at night, your sleep is disturbed and so when your sleep is disturbed you feel tired and dreadful and so you’re more stressed so you have more hot flushes and you go into this very negative cycle of thinking, “I really can’t stand this. I must get some help.” And that’s usually when people come in and talk to us.

 

Marcia calls times when her memory fails ‘granny moments’

Marcia calls times when her memory fails ‘granny moments’

Age at interview: 46
Sex: Female
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The memory is really bad. I mean just this morning I picked up the credit card, thought I’d put it in the tea [room] and went to look for it, couldn’t find it and had to call one of the staff members to come and look. So yeah, the memory is getting affected. I go upstairs and you can’t remember what you’ve gone upstairs for. And I’ve got two children and I can’t remember their names. I call them vice versa names. And I notice sometimes when you’re talking you can’t remember what you were going to say next and you go “um, er, er, er, er” and then it comes back to you. Yeah.

And that started pretty much when your periods stopped did it?

Yeah, I noticed it more, I call them my granny moments and I run upstairs and I call “Ah, you granny”.

Poor memory, forgetfulness and difficulty concentrating can cause problems at work and at home. Women had difficulty taking in and processing information, finding the right word, remembering details, spelling, answering emails, and organising tasks. They felt ‘bombarded’ when asked to take on too many tasks and embarrassed when they forgot what they were saying in the middle of a conversation or couldn’t recall what people had told them.
 

Geraldine struggles to remember appointments and details of what she’s read at work. At home she...

Geraldine struggles to remember appointments and details of what she’s read at work. At home she...

Age at interview: 49
Sex: Female
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My memory now that is the one thing, memory. Terrible. Oh, I mean I know probably as you go on, as you get older your memory isn’t as good anyhow but oh, my memory is just shot to pieces. I don’t remember, I mean at times I worry about will I be able to continue working because my memory’s so bad. And just I never remember. I mean I suppose it’s a generational thing. My son’s always going, “I told you that.” I think, “I know you did.” But I don’t remember he’s told me, I think, “Well, I know you did but I can’t retain that sort of information.” I don’t lose words. People say they lose the words for things. Now that hasn’t, as yet, happened to me but it’s my memory generally.

So how does it affect you?

I have to write everything down in work. If somebody says, if you phoned me this morning and said, “Jenny will be in to see you at 2 o’clock.” At 2 o’clock somebody will phone me and say, “Jenny’s in to see you.” And I go, “Oh, I completely forgot she was coming.” Things like that or my son would say, “I’m working [da da da] this week.” And I wouldn’t remember. I mean I would know that he’d told me and I even make a mental effort now to try and remember it because I know he’ll go, “I told you that already”. But it’s those sort of things that I forget. I wouldn’t remember details, like I mean obviously I have a lot of keeping up to date with tax and things like that and I would read articles and it used to be I’d read them and they’d go in and I’d remember about them but now I sort of think, “ I think I read something somewhere about that.” Whereas before even if I didn’t remember the exact details, I would remember where I’d seen it and be able to lay my hands on it. It’s things like that which, as I say, I don’t know whether that’s the menopause or whether that’s just getting older anyhow.

So what effect does it have on your job do you think?

Probably none really so far. It’s just that I’m more aware of it and when I forget things and I think, “How could I forget that? Is my memory that bad?” And that just makes me start to think if I can forget that, is it going to start affecting my job. So far I’m not aware of it doing so apart from having to write everything down and where I phone somebody and I say, “Okay, I’ll do that for you.” And then I get another phone call straight away before I’ve had time to write it down, I have to remember and I’m like the next day think, “I didn’t do that.” But, so far there have been no disasters.

 

Maria has ‘scatty’ moments at the grocery checkout when she ‘says numbers backwards’

Maria has ‘scatty’ moments at the grocery checkout when she ‘says numbers backwards’

Age at interview: 43
Sex: Female
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I do have moments as well when I’m scatty. I don’t know if that’s a combination of it but I go a bit scatty. I forget what I’m saying or forget what I’m doing and yes, so those are my moments. Yeah and it’s exactly the same as what my mum went through.

It’s strange, I don’t know if it’s just us, but for instance, you’ve come to the checkout, you’ve bought your shopping, the total’s fifteen pounds. I might say ten and I look and I can see fifteen there or I say numbers backwards. I just laugh, customers know me. I’m always laughing and I think that’s just to hide the embarrassment really because I’m thinking, “What am I doing?”

Loss of memory and poor concentration can be annoying and sometimes funny, but women also found it frightening. When memory and organisational skills are affected by the menopause, working at a high or senior level can become almost impossible. Trying to hide memory losses can be exhausting and add to the stress of the menopause. Women wondered whether their inability to remember things might be not just an unwelcome menopausal symptom but a sign of something more sinister. One questioned whether her poor memory had to do with the menopause, getting older, or the ‘plaques in my brain starting to fur up’; another found her recent misspellings out of character and wondered if it was an ‘early sign of dementia’.
 

Joyce was very frightened by her poor memory and concentration at work. She wondered if she had...

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Joyce was very frightened by her poor memory and concentration at work. She wondered if she had...

Age at interview: 48
Sex: Female
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I think I’m a reasonably intellectual person, I’m educated to degree level, I hold a responsible and a senior position whereby I need to deal with complexity, just about daily in my job, I need to be able to deal with ambiguity, and I need to read a lot, take in information and be able to store it and then use it. I had no problems doing that up till the age of 45, 46. But in those 18 months that I’ve just described from being sort of 46 and a half, I’ve found that incredibly difficult, it got more and more difficult, and it really started to trouble me. And what would happen, for example, would be I would have lots of things to read, or I would be reading about something, an issue that was maybe new or unfamiliar to me. And I would be given a briefing paper or some information about it and I would be reading the words but they wouldn’t be computing in my brain. So the words would go in and it’s almost as though they went into a vacuum.

And I found this really unnerving, really unsettling. And I actually began to question whether, I thought I actually had the early onset of Alzheimer’s. That’s how bad it was. It really really troubled me; I thought I was going mad. I also found that my memory both short term and long term was absolutely appalling on occasions. And this is where it got a bit scary, because sometimes I would have no problem with my memory whatsoever. On other occasions the most simplest of things would simply desert me. So, an example of that was, I was in a meeting with my top team, my executive team one day, and I was asked for some details on a project that I’d been working on for about fourteen months, now I should have known these details back to front, inside out, I’d lived this project for such a long time. And I couldn’t remember the order of something. And I found it very difficult not to cry, and in fact I was saved by the bell literally, because my phone went at that point, and I was able to exit out of the room. And I remember going to my office thinking, “Why can’t I remember this? I’m being asked something very simple, what’s the order of something, and I simply cannot remember it.”

And I actually then started to get quite worried, and I suppose this coincided also, I suppose what concerned me was, this coincided with a time of quite high demand on me professionally, and so what I wasn’t certain about was, is this hormonal and down to the menopause? Or is this because I’m under huge pressure at work? Or is it the combination of things?

But the upshot of this difficulty in concentrating and being able to take information, and this loss of memory, I would describe as somebody’s taken the chip out of my brain. The information’s going in, either through my eyes because I’m hearing it, or whatever, but it’s going into this empty space, and it’s not slotting down into the bits of my brain where I should then be able to understand and comprehend it. And I found that very very frightening.

Things I found really difficult were composing a letter, trying to write a letter to somebody and convey the sentiments and thoughts I found difficult and trying to verbally convey to people, say in a meeting or just on a one-to-one basis, how I was feeling about something I’d find really difficult because I wouldn’t be able to pull up the right words I wouldn’t be able to pull them out of the hat. On more than one occasion I sat in my office wanting to cry, getting the dictionary out, because my dictionary’s got a thesaurus bit, thinking I know the word I want why can’t I remember the word? Why won’t the words come back? It was awful, absolutely awful.

Ways of improving memory and concentration
Women recommended some simple strategies which they’d found useful in improving their memory and concentration. These included writing everything down, making notes and ‘to do’ lists, keeping a diary, having a calendar in the kitchen with everyone’s birthday on it, and using spell check. Just sharing experiences of memory problems with other women can be reassuring.
 

Mary’s notebook and electronic diary have been indispensable in running her business

Mary’s notebook and electronic diary have been indispensable in running her business

Age at interview: 57
Sex: Female
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It seems like everything kind of disintegrates but the worse thing is the memory. It is the worst thing. The lack of concentration, the appalling inability to remember people’s faces and names, forgetting appointments. I was running a two million pound operation I couldn’t afford to forget a thing. So, I developed coping strategies but if you’ve always had a really sharp memory it’s extremely hard to admit.

What sort of strategies did you come up with to help?

Notes, all the time. Notebook, notebook. All the time notebook. If ever I said to somebody, “Oh, I’ll send you one of those” or “let me get in touch with you and talk to you about such and such” or “I’ll ring you and we’ll make an appointment” I would, the first moment, I would even disappear into the loo to do it. I would go into the loo, get my notebook out and write send such and such to Fred or ring Jean to fix an appointment to meet John. It was the only thing I could do. It was absolutely impossible. And I developed the electronic diary as being an important thing with massive numbers of reminders that come up which say do such and such, buy such and such, go to such and such.

 

Christina felt reassured to find that other women had similar problems with memory. She talks...

Christina felt reassured to find that other women had similar problems with memory. She talks...

Age at interview: 52
Sex: Female
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Yeah, I mean you forget, it’s normal to forget some things but if I started feeling, “Oh, hang on a minute.” And then people were saying, “Well, I told you that yesterday.” And I thought, “No, I’ve forgotten that.” And so now as I said, I have to write things down otherwise it goes in there and out there and it’s not maintaining in here. So I don’t know whether, and then you start thinking, “Oh God, I’m going senile.” Or it’s the start of something else and then sitting down and speaking to somebody else regarding their problems with the menopause you think, “Well, hang on a minute. That’s the same.” So I’m not going mad or anything else and then getting the little coping strategies on how to, like writing things down and making sure you’ve got your pad, and you write things. And especially with my boss, you’ll write three pages but then you turn the page and you forget what’s on there so you have to keep on going back and saying, today’s date is, and this is what I’ve got to achieve today.

 

Cynthia’s friends at work ‘fill in the blanks’ for each other when they can’t remember things

Cynthia’s friends at work ‘fill in the blanks’ for each other when they can’t remember things

Age at interview: 54
Sex: Female
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The forgetfulness isn’t helpful but I’m not sure that that’s necessarily menopausal. I think that’s partly an age thing and words. As I’ve just said, using the wrong words and forgetting words but because now I’ve worked with these people for quite a few years and we are all having the same problems we fill in the blanks for each other without missing a beat. And post-it notes come in really handy. They’re stuck all over the place at work.

Summarising information by drawing diagrams or ‘mind maps’, using word or letter associations, or simply repeating important points can be useful memory aids. Keeping the brain active by doing crosswords and doing adult education courses helped some women.
 

Rebecca describes how she tries to recall people's names by going through the alphabet

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Rebecca describes how she tries to recall people's names by going through the alphabet

Age at interview: 57
Sex: Female
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My memory is probably the thing that I think, God, I can’t remember things or names just go out of my head and I find that frustrating as well. And I don’t know whether it’s to do with the menopause or it’s to do with getting older or my plaques in my brain starting to fur up or whatever, I don’t know. I’m not sure but I’ve noticed it definitely in the last few years but most of the people that are my age seem to be the same so I get some sort of comfort from that, that at least I’m not the only one. It’s only when you’re with younger people and particularly at work sometimes when you couldn’t remember things and or even names, you think, “Oh.” But if it was somebody the same age as you, you don’t feel as bad then sort of thing or with my children sometimes I think they’re noticing it as well that my memory’s not so good.

And saying that, it’s not stopping me doing anything and I have ways around it. Even thinking about names, if I can’t remember the name of somebody I go through the alphabet and then I think if I still can’t remember I think it’s maybe a C or a D I would think about DE, DA, DO, DU, trying to think of names round that way so I have ways round it if I can’t remember or at the end of it, I would just ask sort of thing.

 

Doing a degree, crosswords and mental exercises have helped Anne’s memory.

Doing a degree, crosswords and mental exercises have helped Anne’s memory.

Age at interview: 58
Sex: Female
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Yeah, I would say loss of memory, I mean I’m absent minded. But I’ve found doing my degree helped enormously. So I found I was much more focused when I was doing that. And also I was concerned about revising for exams and but I found I probably had to work harder than I would have done twenty years ago but no, I did very well in my exams in the end but I worked really hard. Actually I used to go to revision classes whereas I probably wouldn’t have needed to in my youth. And now I do crosswords and I find if I’m doing sort of mental exercises then my memory’s better but I am absent-minded. I mean I can lose car keys or the front door keys or forget things so yes, I would say that is quite noticeable. Or I’ll put things away or not remember where I’ve put them.

As tiredness can affect memory and concentration, it’s important to try and reduce the effects of symptoms on sleep (see ‘Sleep’). There is no evidence that hormone replacement therapy (HRT) can improve memory loss, but women who use it may find it indirectly improves their memory by relieving hot flushes, sweats and other symptoms which disrupt sleep (see ‘Hormone replacement therapy (HRT)’). While complementary therapies may also help reduce menopausal symptoms, no evidence so far supports claims that herbal remedies such as gingko can help with memory problems (see ‘Complementary therapies’).
 

Joyce's memory and concentration began to improve after a few months of taking HRT

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Joyce's memory and concentration began to improve after a few months of taking HRT

Age at interview: 48
Sex: Female
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And my GP agreed to give me HRT for three months to see how it worked. And I remember literally snatching almost the prescription out of her hand, racing to Boots and saying, “You have got this haven’t you?” Sitting in the car, outside Boots the Chemist, reading the booklet that came with the tablets and going through these are the symptoms that HRT will alleviate, and these are the symptoms that it won’t and I remember it saying this will not alleviate memory loss. And I remember thinking “Oh shit, that’s not going to work then is it? Oh bother, that’s not going to work. And so I just thought “Oh well, we’ll give it a go.”

Certainly the hot flushes and tiredness was definitely alleviated. The memory issue wasn’t immediately and I think over the four months, five months now that I’ve been taking it that’s gradually improved. I wouldn’t say it’s perfect and even now I’m struggling to remind myself of the name of somebody that I wanted to tell you about. But I don’t think it’s as bad as it was. And the most startling thing has been the ability to concentrate and I feel like my brain just went back into place.

At times even simple strategies designed to help memory loss can fail. One woman sums up her frustration, ‘I wrote down everything in my diary, even the littlest things. And then I’d forget the diary’. But many women find their memory and concentration returning to premenopausal levels as symptoms ease and sleep is restored after the menopause. If you have any concerns about your memory, however, it’s best to see your doctor to rule out more serious conditions such as dementia.





 

Last reviewed July 2018.


 

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