Bioidentical Hormones: Easing the Menopause Transition

For years, women have struggled with the changes that come along with menopause. From hot flashes to mood swings, this transitional period in a woman’s life can be quite challenging. A lot is known about the physical symptoms of menopause and their underlying hormonal physiology; however, a less widely researched topic is the effect menopause has on a woman’s mental health-that is, until now.

The idea that a woman in her mid-50s could be experiencing memory loss and cognitive changes may seem unheard of to most, but for neurologist Dr. Devi, it was becoming commonplace. More and more women were being referred to her New York City practice with new cognitive and behavioral issues under the suspicion that serious neurodegenerative diseases may be the cause. What Dr. Devi discovered, however, was that all of these patients were undergoing or had undergone menopause within the past two years. She then drew a link between the estrogen deficiency that accompanies menopause and these mental changes. She found that the brain receives profound stimulation from estrogen, and when these hormone levels fall during menopause, so does the patient’s ability to perform simple tasks such as making plans or keeping track of belongings. She began diagnosing these patients with menopause-related cognitive impairment and implementing a new treatment plan that involved hormone-replacement therapy. In one patient’s case, her behavioral symptoms and memory loss had fully resolved in only 15 months. After treatment, she was able to complete a demanding graduate program and take on a new position at work, highlighting the impressive benefits of hormone replacement.

Despite the growing evidence supporting estrogen deficiency as the cause of so-called “brain fog” in menopausal women, Dr. Devi believes that this is being overlooked in too many women. Internists are often looking for infectious causes or perhaps thyroid disease, thus patients are not receiving the correct diagnosis. For that reason, Dr. Devi chose to publish her research in the journal Obstetrics and Gynecology, with the hopes of bringing more attention to this disorder. She also received support from Dr. Pauline Maki, a psychology and psychiatry professor at University of Illinois Chicago. Dr. Maki noted that perimenopausal and menopausal women not only more often report cognitive difficulties, but also perform more poorly on neuropsychological tests as compared to premenopausal women. Both Dr. Maki and Dr. Devi came to the same simple conclusion: while menopause is unavoidable, the best thing that can be done for patients is to normalize the experience. Through reassurance and subtle hormone supplementation and replacement, this difficult time in a woman’s life can be made much more manageable.

In addition to the cognitive benefits, bioidentical hormone replacement therapy for menopause has many other perks as well. One study found that women who began hormone replacement in their early 50s had lower mortality rates and incidence of Alzheimer’s at an 18-year follow-up. Hormone replacement has also been found to minimize physical and emotional symptoms, such as hot flashes, night sweats and mood swings. Additionally, the use of bioidentical hormones as opposed to synthetics reduces the risk of cancer as well as other side effects. Overall, the message is clear: bioidentical hormones can help ease the transition of menopause and improve the overall quality of a woman’s life.

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