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Menopause could explain that word forgetfulness and weight gain

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Over the past 22 years, I have had the pleasure of taking care of men, women, boys, girls, the young, and the elderly. However, the bulk of my practice is probably women. As we celebrate women during Womens History Month, I thought we should highlight an area that often elicits spirited discussion among middle-aged women. Topic of choice: MENOPAUSE!
I must admit prior to my becoming a middle-aged woman, I did not understand all of the hype around menopause. I recall a few lectures in medical school and in residency but did not realize how not having periods fully impacted women. As a more mature female African-American doctor now, I am appalled at the limited education I received at my male-dominated, Eurocentric institutions.
symptoms
Women have also reported issues with word finding, forgetfulness, and brain fog during this phase.
Menopause is defined as amenorrhea- not having a period for 12 months. Menopause is also more than just not having periods. The hormonal fluctuations occurring in a womans body are affecting more than just her female organs. Menopause is a full body experience with lifelong consequences.
Dr. Denise Hooks-Anderson
Photo by Jennifer Sarti | St. Louis American
On average, the menopausal transition begins at age 47. During this phase, women are still having periods but periods may be irregular and bleeding can either be lighter or even heavier. The highest rates of bone mineral density loss are experienced one year before a womans final menstrual period and up to two years after. 32-40% of women experience sleep disturbance during the early menopausal transition stage. Women have also reported issues with word finding, forgetfulness, and brain fog during this phase.
No Estrogen
For women who do not take estrogen in the early post-menopausal years, they typically gain fat mass and lose lean mass. This extra fat is often seen in the abdomen and causes much psychological distress for women during this time.
Hot flashes are probably the most recognizable symptom of menopause. These temperature surges can occur during day or night and typically last from 2-4 minutes. This feeling of warmth is often associated with perspiration and can sometimes be followed by chills. Women often attribute their disrupted sleep to the night sweats. Obesity, lack of physical activity, genetics, and ethnicity are risk factors for hot flashes. African American women report more frequent hot flashes than caucasian women.
Research studies have shown that estrogen is important for optimal health in many areas. For instance, estrogen is important for cognitive function. However, the impact of estrogen deficiency, the consequences of hormonal changes, and estrogen treatment are uncertain. Estrogen deficiency can also impair balance and may contribute to osteoarthritis.
For women who do not take estrogen in the early post-menopausal years, they typically gain fat mass and lose lean mass. This extra fat is often seen in the abdomen and causes much psychological distress for women during this time. Skin changes are also seen in menopause. Estrogen deficiency causes reduced collagen content which leads to increased aging and wrinkling of skin. Limited data exists on whether estrogen improves the changes in collagen.
Even though menopausal symptoms affect most women in some way, few women actually seek treatment. This may be due to lack of knowledge or some archaic belief that this natural phase of a womans life is to be endured and not treated. Depending on the type of symptoms, there are several different treatment options available for women. Treatment options are environmental, non-hormonal, and hormonal. If you are experiencing menopausal symptoms, speak with your primary care provider or gynecologist for a personalized treatment plan.
Denise Hooks-Anderson, MD, FAAFP Family Physician, The St. Louis American Medical Accuracy Editor, can be reached at

Wednesday, March 15, 2023 at 12:00 am

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