New research on hot flashes, brain fog & exercise in menopause

Research on menopause — and women’s interest in it — keeps growing. But as new information rolls out at such a dizzying pace, it’s impossible to keep up. With everything so accessible now, where do you start and when do you stop? And, it doesn’t help that newer studies often change the messages that we’ve already being told.

As a doctor, I want to lessen any confusion you may have about menopause and what the new research means to you. The latest findings tell us a lot about hot flashes, memory problems and exercise, including information you can use to reduce troubling symptoms and feel better.

Suffering from hot flashes?

If you’re one of the 50-80% of midlife women who have hot flashes, you’re all too familiar with that sudden sensation of heat in your body that can quickly spread through the chest, neck, and face and cause you to urgently peel off layers while everyone else around you seems perfectly comfortable. Hot flashes can be joined by other unsettling symptoms, like chills, perspiration, anxiety and night sweats — waking in a pool of perspiration with a racing heart.

The latest research about hot flashes

Much of the literature tells us that these annoying symptoms (collectively called “vasomotor symptoms,” or VMS) will last from a few months to a few years. Recent studies, however, suggest that hot flashes can last more than a decade for many women. Here are two examples of what researchers are finding:

• One of the longest-running and largest studies on the subject revealed that some women had symptoms for as long as 14 years.
• A survey of 2,020 menopausal Australian women revealed that 6.5% of them suffer symptoms into their mid-60s. Even a meta-analysis reporting a median symptom duration of only around four years found that 10% of women in these studies were still symptomatic 12 years after their final menstrual period.

What you can do for your hot flashes

How can you predict how long your hot flashes could be a problem? It appears that the earlier your hot flashes appear, the longer they could last — and you may want to consider your options for hot flash relief.

In one study, 14% of women with early debilitating symptoms had already had hot flashes three years before menopause.

Another study compared the median duration of hot flashes for women who developed them at different stages:

• Women who developed hot flashes while still premenopausal: 11.25 years
• Women who were flushing as they entered menopause: 7.35 years
• Women who started flushing a few years into menopause: 3.84 years

No matter when you begin having hot flashes, luckily there are many ways to reduce them, including stress management, mind/body therapies, specific herbs such as those found in Herbal Equilibrium, soy isoflavones, nutrients, and limiting alcohol and caffeine. I encourage you to see why herbal remedies for menopause are so effective.

Brain fog in menopause: Is it real?

Do you ever wish your brain had windshield wipers — a few swooshes and everything could be clear again? It’s disconcerting to be used to a clear focus and then lose it, or having good recall for names and then suddenly come up empty. This is especially scary when “bad days” turn into weeks or months and you have no idea how to turn it around.

Brain fog and memory problems have many different causes. But if you’re around 50 and your focus is getting fuzzy as your periods become irregular, you can probably blame menopause. Brain fog and menopause brain may be in your head, but not in your imagination — it’s real.

The latest research about brain fog

Brain fog is real, but it’s more like a temporary hiccup in the learning process during perimenopause.

Studies are finding that perimenopausal women with forgetfulness not only have trouble staying focused, but also have a harder time learning new information. While the brain activity needed to learn to play an instrument or memorize a poem continues during menopause, the process is slower in many women during perimenopause. This is compared to their younger — and even older — counterparts. Previous studies, reported similar findings — once women hit perimenopause, they couldn’t learn as easily as they could before.

Memory problems in menopause usually show up within the first year of a woman’s final period. Estrogen levels can fluctuate wildly at this time, sometimes rising higher than premenopausal levels.

Studies that measured the women’s hormone levels found no correlations with their cognitive function. Keep in mind, however, that a single test at one point in time can’t detect the hormonal ups and downs characteristic of perimenopause. The parts of the brain that support verbal and working memory are rich in estrogen receptors, so it’s conceivable that a woman’s brain during perimenopause is extra sensitive to these hormone fluctuations. Estrogen supports the growth and survival of neurons, and also plays a role in serotonin and HPA-axis regulation, important in mood.

What you can do for your memory

Rest assured most memory problems in perimenopause are not signs of early Alzheimer’s. The fog usually clears once your body has stepped off the roller coaster and your estrogen levels stabilize.

For example, in a four-year study that followed 2,362 midlife women, those in premenopause and postmenopause showed consistent improvements in test scores over time, whereas test scores among women in perimenopause didn’t budge. So, it’s the transition that can be a bit crazy-making, not menopause itself.

As for long-term memory risk, dementia risk appears more influenced by cardiovascular risk factors, which can mount during menopause. Consider the transition into menopause an opportunity to get thoroughly checked out and improve your overall health.

Do I really have to exercise? I’m tired!

64% of middle-aged women who got less than three 30-minute sessions per week of moderate activity like walking had worse menopausal symptoms.

We know exercise is good for our health, and it’s especially true for women at midlife, when our body composition changes in ways that cause disease risks to climb. Ironically, this is also a time when our energy levels can plummet and making it harder to keep moving.

Unfortunately, inactivity can lead to worse menopause symptoms. In a large study done this year, 64% of middle-aged women who got less than three 30-minute sessions per week of moderate activity like walking had worse menopausal symptoms, and more depression, anxiety, insomnia, and obesity than the more active women.

The latest research on exercise in menopause

For women who have limited time, there is good news about exercise and menopause. While it makes sense that an active lifestyle would produce opposite results of a sedentary one, many studies show moderate exercise can impact body composition and disease risk in middle-aged women:

• Only 30 minutes of brisk walking three times weekly reduced menopausal symptoms, lipids and weight in perimenopausal women.
• Two hours a day of standing or walking around the house was associated with a 9% reduced risk of obesity and a 12% reduced risk of diabetes. After meal spikes in glucose and insulin can predict the development of type 2 diabetes. Remarkably, a leisurely 15-minute walk after eating can reduce glucose spikes by 50%.
• Many studies have shown how regular exercise can increase energy, reduce menopausal symptoms, prevent obesity, support brain function, promote a sense of well-being, support bones and joints, decrease inflammation, and reduce risk of diabetes, cancer, cardiovascular disease, dementia, and premature death.

Although every little bit helps, the research comparing levels of physical activity consistently show the more you move, the more you benefit. That said, research also shows that you don’t need to do intense exercise for hours a day to see real benefits in how you feel and for your long-term health.

Good news about moderate exercise in menopause

As you start moving, your energy will rise; as you keep moving, your health will improve.

Any overextended, overtired woman knows how hard it is to stick with an exercise program. In my experience, finding an activity you enjoy helps keep exercise a priority. Walking is a great starting point — gentle and accessible to everyone. Consider this time of life as an opportunity to improve your overall health, with a regular exercise program being part of it. As you start moving, your energy will rise; as you keep moving, your health will improve. Invite a friend to join you, and get going!

How moderate exercise benefits your health

A big step to feeling better

Somewhere along the way, not feeling your best in menopause might have started feeling normal. After all, most of us spend the majority of our day taking care of others, whether it’s children, parents, friends or work colleagues, so finding the time to try to get through all the information about own symptoms can easily fall to the bottom of the to-do list. So I want to congratulate you for taking this step of understanding your symptoms and what’s happening in menopause. You’re already on your way to feeling better.