Menopause and the Mind: The Complete Guide to Coping with Memory Loss, Foggy Thinking, Verbal Confusion, and Other Cognitive Effects of Perimenopause and Menopause - Hardcover

Warga Ph.D., Claire L.

Hardcover

ISBN 10: 0684854562 ISBN 13: 9780684854564

Publisher: Free Press, 1999

Synopsis

In a unique guide, a neuropsychologist offers insight into the mental disruptions that often accompany the onset of menopause, including lapses in memory; presents self-screening tools; and identifies treatment alternatives, from estrogen therapy to dietary changes. 50,000 first printing.

About this title

About the Author

Claire Warga, Ph.D. is an experimental psychologist who also works with patients as a New York State-licensed psychologist specializing in health psychology. She has researched the brain/body/mind/physiology frontiers in studies on pregnancy, Alzheimer's disease, sleep, and the psychophysiology of emotions. Warga trains health and mental health professionals, consults, and lectures on mid-life health and research topics; she has also interviewed many of the world's leading scientists as a medical/science journalist. She lives with her family in Brooklyn Heights, New York City.

Reviews

The author of the much-discussed 1997 New York magazine article "Estrogen and the Brain" aims to bring public and professional attention to a decade of new research on the link between hormonal change and lapses in the cognitive faculties of women in the years leading up to and during menopause. Citing studies that relate declining estrogen levels to a range of "slips" in memory, speech, thinking, attention span and sense of time and space, Warga makes a fascinating argument for the biological, even evolutionary basis of such behaviorsAin men as well as women. An advocate of hormone replacement therapy to reverse these symptoms, Warga, a Ph.D. in neuropsychology, is highly skilled at making science accessible to the general reader. The book's emphasis, however, is on identifying and establishing a medical syndrome the author calls WHMS, for Warga's Hormonal Misconnection Syndrome, that she contends is separate from the physical symptoms associated with menopause. Readers, especially women from 35 to 60, who have experienced frustrating and sometimes frightening "senior moments" may welcome the book, but they should understand that less than a quarter of it deals with treatment and coping strategies. For those unable or unwilling to take synthetic hormones, there are helpful suggestions about estrogen "mimics," including serotonin boosters, exercise and a dietary regimen that includes moderate amounts of sugar and caffeine.
Copyright 1999 Reed Business Information, Inc.

A significant heads-up for women over 30, along with reassurance and a detailed action plan: yes, there are measurable cognitive changes that occur in midlefe as a result of changing hormone levels, and yes, there are pharmaceutical, dietary, and other measures that can be taken to alleviate or even reverse the changes. Warga, a neuropsychologist, aims this book at educating women and their physicians, as well as pointing health-care researchers in the right direction for more thorough investigation. The root cause of the syndrome (which Warga dubs Warga's Hormonal Misconception Syndrome, WHMS) is dropping estrogen levels. It includes a range of intermittent disturbances or lapses in memory, speech, attention, behavior, or thinking. Part two of this volume looks at the cause: Warga explains clearly the current understanding of the neurochemical interplay between estrogen and the brain. Part three sets out thorough screening tools for self-diagnosis. In part four, Warga gives extensive, thorough advice on alleviating the symptoms and correcting the cause: hormone replacement therapy, glucose, phytoestrogens, antioxidants, antiinflammatories, along with mental exercises and drills, and learning new ways of focusing on tasks. Choosing the right health- care provider is paramount: choose someone who is knowledgeable about the existing evidence, understanding of the problem, and alert to new treatment options. This book offers validation and hope for those affected by the syndrome. A welcome, emminently worthwhile guide. -- Copyright ©1999, Kirkus Associates, LP. All rights reserved.

WHMS, which stands for Warga's Hormonal Misconnection Syndrome, is a convenient umbrella term covering the problems listed in the book's subtitle. A person has to have a certain confidence to name a syndrome after herself. Neuropsychologist Warga identifies problems faced by many women that involve not knowing what is happening to them and fearing Alzheimer's or the possibility that they are losing mental control. Warga relates such problems to menopause and documents her assertions with solid medical and scientific literature. Her book aims at two large groups: women who have long struggled with the problems covered, and physicians who either do not know about such conditions or do not care. Warga sounds an individualizing note by citing a variety of case histories, and she discusses current research and points out where additional work is needed. For those who can't take estrogen, she offers alternative approaches. The matters she covers are constituents of a rapidly growing field, and this book has much to offer. William Beatty

Mood swings and other more severe psychological disorders during perimenopause have already been documented and attributed to estrogen deprivation (Marcia Lawrence's Menopause and Madness, LJ 4/15/98). Here, neuropsychologist Warga focuses on the cognitive deficits that result from estrogen loss, detailing such changes as losing one's train of thought, the "what did I come here for" sensation, having the wrong words pop out, reversing words while speaking, briefly forgetting how to do things, and experiencing erratic fine motor coordination. She postulates the existence of Warga's Hormonal Misconnection Syndrome to describe these symptoms and suggests remediesAhormone replacement therapy as well as nonhormonal approaches involving glucose, antioxidants, anti-inflammatory agents, aerobic exercise, and behavioral training. Although one might chide the author for naming her theory after herself, her book is reassuring and worthwhile. Recommended for consumer health and health sciences collections.ALinda M.G. Katz, Allegheny Univ. of the Health Sciences Lib., Philadelphia
Copyright 1999 Reed Business Information, Inc.

Excerpt. © Reprinted by permission. All rights reserved.

Chapter 1

What Are These Strange Symptoms I'm Experiencing in the Middle of My Life?

Mrs. Malaprop: a character in Richard Brinsley Sheridan's 1775 play The Rivals. "A...woman of almost fifty [emphasis added] who...is famous for misusing...long words that sound similar to the correct words."
-- Larousse Dictionary of Literary Characters

Malapropisms: the type of verbal errors made by the character Mrs. Malaprop.

There are some topics almost no one talks about till you do first. The stampede for the male impotence drug Viagra unveiled one such topic. This book is about another one: the previously unrecognized cognitive symptoms that are caused by the effects of perimenopause and menopause on the mind.

Sometimes it begins out of the blue with occasional slips of the tongue, meaning to say one word and unexpectedly hearing another pop out. Or when you realize that you, once a champion speller, aren't so sure anymore how to spell "potato" or "forty." Sometimes it begins with uncharacteristically forgetting important appointments or drawing unexpected momentary blanks -- total blanks -- when it comes to remembering your only child's or best friend's name, or how to turn on the computer you've been using for years. Sometimes with feeling mentally "hazy" "foggy," or "spacey" and not being able to clear things up though you need to be "sharp" at that moment. "What's happening to me" you wonder. "Could this be early, early, early Alzheimer's disease or a brain tumor?"

But it is usually not early Alzheimer's disease or a brain tumor. It is something else, a particular set of symptoms -- a syndrome -- that can occur in women beginning in their mid to late thirties or in their forties or fifties that more than likely can be halted and even largely reversed according to the best evidence available today. It is a syndrome associated with estrogen loss that is mainly experienced from within, and that until now, amazingly, no one has recognized as common among women or has linked to the wealth of post-1990s research evidence revealing the many important newly discovered roles estrogen plays in the remembering, naming, and attending parts of the brain. This is research that helps explain why the symptoms occur and why they can often be reversed.

"I'm losing it," women say. "I'm going out of my mind," "I'm falling apart at the seams." "I'm flipping out." "I'm cracking up." "I'm having a nervous breakdown," "I'm just not myself." "I don't know what's wrong with me." "I do the strangest things." "I think I'm getting early Alzheimer's."

These are not the hysterical rantings of women with vague psychosomatic complaints but rather the blanket descriptions frequently used by perimenopausal (women experiencing or undergoing changes associated with the shifting hormonal functioning of the ovaries that precedes the last period. Symptoms can begin four to fifteen years before menopause.) and menopausal (women who have had their last period twelve months ago) women to describe the dislocating experience of confronting an assortment of unpredictable mind, speech, and behavioral "flash" symptoms. These are surprising symptoms no one has ever prepared them for. Physicians hearing these dramatic statements over the years have simply had no basis in training for understanding what they were hearing and as a result have been able to offer no, or minimally constructive, help to women who dared to mention them.

THE SYMPTOMS OF PERIMENOPAUSE AND MENOPAUSE CAN BE VERY STRANGE BUT NORMAL

Before describing the specific symptoms I am referring to it makes sense first to agree about certain realities of a perimenopausal/menopausal symptom you already do know something about. Hot flashes. Consider this: If we on earth had never heard of hot flashes as a "normal" midlife symptom associated with ovarian and hormonal changes, and a returning astronaut-discoverer of a twin planet to ours reported drenching, unpredictable, overheating episodes as normal in otherwise healthy midlife-and-older women, we would likely say in quick dismissal, "Go away! You must have gotten something wrong there. The women were probably fooling with you in some way. You couldn't be right. That symptom is just too weird to be true of normal people."

And yet the reality is hot flashes are definitely normal but strange symptoms for healthy women to have. The fact that they are so common makes them seem normal to us. What makes them believable apart from their strangeness is the fact that they are also sometimes observable to others, leaving "tracks" of the internal experience visible to those who don't have them and who might otherwise be inclined to dismiss them as "too crazy" to credit as real.

PERIMENOPAUSAL AND MENOPAUSAL SYMPTOMS CAN OFTEN BE CURED EVEN WHEN NOT FULLY UNDERSTOOD

It's also useful to point out that though science does not yet have a clear consensus on what specific sequence of events produces hot flashes in women -- beyond the bigger picture of changing ovary and estrogen function during perimenopause and menopause -- nevertheless medicine has developed at least one quite effective empirical treatment for hot flashes based on trial-and-error experience, even in the absence of a clear scientific understanding of their basis. Namely, estrogen replacement. (Other remedies that apparently work for some proportion of women have been considerably less tested and proven.) Successful treatment therefore of a symptom associated with ovarian/hormonal changes can precede biological understanding of the full complexity of the symptom.

The broad array of symptoms I have named the WHM Syndrome -- for Warga's Hormonal Misconnection Syndrome -- may at first, I suspect, appear as strange and bizarre as hot flashes do to those unfamiliar with them. But in the years to come, I believe, it will seem one of the great mysteries of our time that such a common, unusual, but apparently typical set of biologically based symptoms could have been overlooked for so long. Cultural and medical historians of the future, I predict, will long ponder the great divide of female patient/doctor non-communication that is implicit in physicians not having "heard" and detected this set of symptoms and its cause in women for so many years.

What WHMS Is Like

The list of possible symptoms I am specifically referring to is presented in Table 1 to help you better understand the cases you will shortly be reading about. (A fuller description of possible WHMS symptoms with examples of how they actually occur in women's lives follows in chapter 7.) In Table 1, however, I list only the mind/speech/attention/ behavioral symptoms to which I have given the name "WHM Syndrome," or "WHMS." This table does not include any of the mood or physical symptoms that are also frequently but not inevitably associated with menopause and the years preceding menopause. (These are more fully described in Appendix I.)

TABLE 1
The WHM Syndrome: Warga's Hormonal Misconnection Syndrome

As you examine the following chart keep in mind that the symptoms below typically occur as brief come-and-go episodes within the context of a functional ongoing nondisabled life, not unlike the manner of hot flashes. Women who experience some of the symptoms need not experience all of the symptoms or even many of the symptoms. Some symptoms may appear similar but are experienced by women as different from each other and are thus listed as distinct, pending additional research. Implied in each symptom is the sense that it occurs with a greater frequency than it did in the past. The symptoms most typically do not occur continuously but in erratic on-and-off intermittent episodes, in the pattern of occurrence of "hot flashes," so eac

Edition details

• Publisher: Free Press
• Publication date: 1999
• Language: English
• ISBN 10: 0684854562
• ISBN 13: 9780684854564
• Binding: Hardcover
• Number of pages: 416