Why Does Surgical Menopause Brain Fog Happen, And What Actually Helps

I. Introduction

I know that I speak for a lot of other women when I say that none of my doctors told me anything about any changes or other issues that might come up in surgical menopause.

So when I first started experiencing some short term memory loss, it was scary! Literally, going from screen to screen on my laptop, I would completely forget what I had just read, only two seconds before!

In this article, I want to explain what “brain fog” consists of, why it happens, how long it lasts and solutions that can help.

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II. What Is Surgical Menopause Brain Fog?

“Brain Fog” is the term for the mental fuzziness and confusion that women feel when they’re in surgical menopause.

Most women label this cognitive issue as “brain fog” or “monkey brain,” and it manifests mainly as forgetfulness, fogginess or mental sludge. It affects executive function and hampers concentration and this was a biggie for me. 

Surgical menopause brain fog is a temporary change in mental function that happens when both of your ovaries are removed before you reach the stage of natural menopause. 

When a woman has both ovaries removed, she is in surgical menopause and most of her hormone production stops. Some women can use HRT to try and replace these very important hormones. Some women, like myself, cannot use HRT.

Natural menopause is much gentler than surgical menopause because symptoms come on slower, and your estrogen production gradually goes down. This allows our bodies and minds the time to get accustomed to what’s happening.

III. Why Does Surgical Menopause Cause Brain Fog? 

I knew that estrogen played a big part in brain health, BUT I DIDN’T know just HOW important it was.

ESTROGEN:

Estrogen helps with the production of serotonin and dopamine and also helps with synaptic plasticity which is the brain’s ability to form new connections, so you can see how that would affect how we learn new things.

Neural pathways that are in charge of memory and focus, can be affected and that’s when we start seeing gaps in our thinking.

IV. When Does Brain Fog Start and How Long Does It Last? 

For surgical menopause, the first few months after surgery, is the median time for the initial onset of brain fog.  Within 6-12 months, the symptoms of brain fog can improve w/out HRT, but it really depends on each individual and factors like age, health and lifestyle.

For women aged 45 or younger, studies have shown that w/out HRT, (hormone replacement therapy,) there is a faster decline of global cognitive function, memory and processing speed. 

Also, the younger a woman is when she is in surgical menopause, means that she has less exposure time to the protective benefits of estrogen.

V. Research Insights You Should Know 

Estrogen has potent neuroprotective effects in our brain and central nervous system.

In one study, 63% of women who’d had a bi-lateral oophorectomy, (removal of both ovaries) experienced brain fog in varying degrees. For some it was very frustrating and for others, it was manageable.

Another study found that 50% of women post surgical menopause had trouble with their memory. This included short term memory, working memory and retrieval difficulties.

An additional study found that 25% of women had problems with increased distractions and problems being able to stay focused. Can you say SQUIRREL??  🐿️🐿️

VI. What Actually Helps: Evidence-Based Solutions

Of course, number one on the list of things to do for “brain fog” in surgical menopause is: (if you can)

A. Hormone Replacement Therapy 

Our brains use estrogen for so many different processes and with HRT, it can help treat some of the negative cognitive effects that happen.

Timing Considerations:

From everything that I’ve read, if you haven’t started HRT right after your surgery, it doesn’t mean that you can’t ever start! It’s recommended that after surgery, to aim for starting by the five year mark if possible, but ten years is the cut-off and by age 60 is the latest that you should start.

Always check with your “menopause trained doctor” to see if you can start HRT.

For those of us that can’t use HRT, we have to go to number two on the list for help, which is lifestyle changes.

B. Lifestyle Interventions 

Sleep optimization:

This was an especially tough issue for me because I’ve had chronic insomnia for most of my life and long before surgical menopause happened. 

I’ve tried a LOT of different natural remedies, pattern changes and medications and ended up being put on Ativan, which helped but I had to be very careful with my use of it.

Sleep is SO IMPORTANT for our cognitive health, especially for any negative effects from surgical menopause! When I miss that precious sleep, I really pay for it the next day. It makes any memory problems you’re having markedly worse.

Exercise:

There are a few current articles saying that HIIT or strength training can help build neural plasticity, which is the brain’s ability to adapt to new neural pathways or even make new ones!

Now that’s exciting!!!

Walking: I sit quite a bit for my blog etc., but I walk whenever I can. Try to do this every chance you get. Make sure to get up every hour and MOVE! Try to walk briskly for a half hour every day!

Stretching: Stretching does many things for me from relieving sore, tight muscles to easing any nerve pain that I might have. 

Yoga: It doesn’t have to be fancy! You can just go to YouTube and look up any kind of yoga for beginners and trust me, you’ll find plenty to choose from.

Weight bearing: Don’t know where to start? If you’re a beginner just use your own body weight! What I’m finding is that some of the most effective exercises are the ones that are done slowly, properly and intentionally.

Stress management techniques:  

If you have an at home job like I do, plan your work time and let everyone know what you’ll be doing and when.  People can’t help you if they don’t know what you need.

Make sure that you have a dedicated place to work. I made the mistake of having my work desk in our living area, trying to be nice. I ended up being so stressed out because I wasn’t in the quiet area that I should’ve been in from the start.

Use calendars and schedule tasks to do to get extra “stuff” out of your mind and onto paper. Breakdown large projects into doable steps.

When you get overwhelmed, it’s okay to get away from the stress. Take a walk, go pet a cat, whatever it is for you.

Nutrition approaches:

Fuel to help prevent “brain fog” would definitely include:

Omega-3 fatty acids, which are “unsaturated fats,” sardines, salmon, anchovies are just a few and soy has been found to help with memory and cognitive maintenance in older women.

This is a great quick article about “why” omega-3 is so important. 

Here’s another one about how many servings of which foods are the best! I think knowing how much of what food is a lot more realistic than just reading which ones to eat.

Don’t skip meals when you’re trying to do something that requires your attention and focus. You’ll end up shaky and frustrated, not to mention that the brain fog will get “foggier.”

What About Supplements?

The supplement that has helped me the most so far with brain fog is Ginkgo Biloba. I was starting to have a REALLY hard time with memory and this supplement started helping in just two weeks!

Another good supplements is Neuriva, and this one has nootropics and it’s in a gummy form, which I really like!

Another really good one that helps with brain fog AND stress is Ashwaghanda. It helps in a subtle way. I didn’t think it was working, until I stopped taking them. Oh yeah! They were working!! 😁😁

I’ve always believed that B vitamins should be a staple for our nervous system and brain health and will give you a good foundation to build upon. A good “B Complex” is what I take.

C. Cognitive Strategies 

Memory aids and organizational tools:

A neat idea that I found was a “notice board.” You would place this in a high traffic area in your home, where you’ll be sure to see it. Use this to jot something down so you don’t forget it later.

Designating certain spots in your home for items like keys, glasses or your phone.

They have “the coolest” things to use for planning and reminders. Like this digital calendar that even tracks heart health.

Mental exercises to train your brain:

I’m always doing some kind of word puzzle if I’m bored and I think anything like that is going to be really good for staying sharp. 

But what about going one step farther and trying to find a brand new hobby, or maybe learning a new language?? What is something 🫵🏻YOU have always wanted to do?

VII. When to Seek Help 

🚩🚩🚩Red flags that indicate something more than surgical menopause brain fog:🚩🚩🚩

The brain fog in surgical menopause is mild and different compared with brain fog associated with other more serious conditions. Plus, you’ll know what to look out for after surgery.

If it hits you very quickly, (suddenly unable to remember your location,) or some kind of mental lapse that would be very out of character for you, that would be an example of rapid onset.

You will have good days and bad days with brain fog, however, if you are going through a rough patch and it starts getting worse quickly or it’s interfering with normal day to day activities like house cleaning or personal hygiene, then it’s time to have a deeper look.

If you ever start having problems with your speech, vision or headaches, you’ll need to be evaluated right away!

Finding a “Good Doctor”

FIND A MENOPAUSE SPECIALIST IN YOUR AREA OR AT THE VERY LEAST, MAKE SURE THAT THE DOCTOR YOU USE HAS SOME EXPERIENCE WITH MENOPAUSE.

So I’m a FIERCE advocate for myself and I have no problems navigating my way through a conversation with my physician.

Remember: Always be totally honest with your doctor. If you drink alcohol or not, use any kind of drug, or have any stressful situations that you may be dealing with…. Your doctor can’t help you with things they DON’T know about!!

Always take a list of ALL medications w/dosages and vitamins/supplements that you take each day.

IX. Conclusion

HRT, consisting of estrogen, progesterone or testosterone, or a combination of all three is the gold standard for treating menopausal brain fog.

AS ALWAYS: THE ABOVE IS FOR WOMEN WHO ARE ABLE AND WANT TO USE HRT. CONSULT WITH YOUR MENOPAUSE SPECIALIST OR DOCTOR FOR INSTRUCTION.

As for the group of us that cannot use HRT, (for any reason,) the other strategies are for prevention and reducing the issues underlying the reasons for brain fog in the first place.

CBT, (cognitive behavioural therapy.) which works to treat stress, anxiety, mood changes and sleep disruptions that all contribute to brain fog. Changing out negative thought patterns for new coping strategies.

Certain anti-depressants can help with mood elevation and decreasing anxiety.

Sleep!! Sleep and brain health go hand in hand! Try to get between 7-9 hours of sleep every night! Being tired just makes everything so much harder, especially brain fog!!😪😫 

Communication with family/friends

Let the people closest to you know EXACTLY how you feel and what’s going on. This is one of those issues that people just can’t see. Except for hot flashes!! 🔥🔥🔥🔥

Be honest and up front and let people know that it’s not personal, that you’re aware of what’s happening and to give you whatever you may need. That might be some time, some space or some extra tenderness or all three.

You might be surprised at how eager people can be to help you!