Jane Brody’s New York Times article about the brain changes of menopause caused by estrogen deficiency (“The Brain Fog of Menopause”, December 17, 2018) is both an example of the growing knowledge about the benefits of post menopausal hormone therapy (HRT) and the continuing confusion and misinformation about HRT, especially about the associated risks.
Most women are aware that hot flashes and night sweats are caused by the loss of hormones in menopause. These symptoms can be life-altering and dramatic, but are not present in every woman, and some women who get them will experience a decline in symptoms after several years, even without estrogen replacement. Changes in mental abilities and emotional changes can be more difficult to characterize as effects of menopause, yet they are just as common and can be profound. Brody correctly points out that “the decline in estrogen stimulation of the brain occurs in ALL women at menopause with varying effects.” Poor sleep, loss of short term memory and a loss of focus and brain vitality can sap a woman of her creative and intellectual power at just the point in her career when she has achieved greater leadership and authority at work.
The article explains in dramatic detail the loss of functionality that estrogen deficiency can cause for women, but falls short by under emphasizing the benefits of hormone treatment, and implies that brain fog may be short lived, and clear up later in life without treatment. In a letter to the editor written by Drs Avram Bluming and Carol Tavris, (NY Times 12/21/18), they correctly note that “it is sadly not the case that menopausal brain fog will fade away” as Brody implies. “Brain fog responds, often dramatically, to hormone therapy…and the risk of dementia and Alzheimer’s in later years drops sharply, by 35 to 70 percent”. Bluming and Tavris conclude “There is no other intervention that comes close to the success rate” of hormone treatment.
Bio-identical hormone treatments offer perimenopausal and postmenopausal women dramatic benefits, with risks that are reduced or eliminated with proper hormone balance and monitoring. The improvement in brain functionality which can occur with treatment can make an enormous difference in a woman’s life, and the benefits are sustained with continued treatment.