One of the things that can become disturbing for a woman or her family members is when some memory changes start to occur. And this can be not remembering what she said, this could be not remembering what someone else said, this could be going into the kitchen and “I came in here to get something and I don’t remember what it is”, it could be not remembering the movie or the book. And a family member can feel like “Wow, she’s just not paying attention to me anymore. She’s just not, she just doesn’t care, she doesn’t pay attention.” But it’s not that. It’s really a change in memory, a change in the ability to recall. Word recall, name recall, trying to speak in a sentence and trying to find a certain word. Not remembering someone walking down the street and it’s kind of embarrassing, “I don’t remember her name”. So those things can become problematic and they can become scary. Because for some women, this isn’t just a hormonal change or just a normal age related change, but it’s the beginning of a progressive change. And we often don’t know at this point and time, especially in the forty-something, fifty-something what it really means. And there is really not great ability to discern “is this a terrible problem, is this a minor problem?”. And often, the doctor needs more time to elapse to understand what is the nature of the situation here. Alzheimer’s disease is far more common in women than it is in men. And that’s because of this whole estrogen deal, we think, and the brain. So it’s not surprising that women have more Alzheimer’s than do men. And there are other things like osteoporosis which is related to menopause is more common in women than in men because it’s more estrogen mediated than it is testosterone mediated. But, I’m getting distracted away from memory.
So one of the ways that the hormonal changes can affect our brain chemistry, it could result in anxiety, I mentioned that briefly as part of the mood changes. But anxiety in particular might need a little bit more attention in that it can be mild, just feeling, waking up in the morning and just feeling a little “off”, a little anxious, or lying in bed at night and worrying a little bit more. Being a little bit more anxious about going to the party or going to another social event. But it can also become much more significant and even severe. There are women that never had an anxiety syndrome, never had panic attacks, and now all of a sudden are in the emergency room with chest pain, heart palpitations, shortness of breath, and there is nothing wrong with their heart. It’s a bona fide panic, anxiety attack. And that is a part of this whole hormonal influence on our brain chemistry is worrying more, anticipatory anxiety, stressing about upcoming events. Any way, shape or form, just feeling more anxious. Being more sensitive too to what someone says. You know your husband says something “did he really mean this? did he mean that?” being anxious that he’s… even paranoid. Maybe more jealousy coming up around this anxiety syndrome can happen all mediated by these hormonal changes.
Often women ask me the question is “how long is this going to last, Dr. Hudson?” and “when is this going to end Dr. Hudson?” and I wish I could answer that question “it’s only going to last this time”, but the truth is it’s…I can not. It’s unpredictable. It’s different for all of us. The severity is different for each of us, the duration is different for each of us, which symptoms we have on this long list of potential symptoms is different for each of us. But, on an average, according to the research, menopause symptoms for seventy five to ninety percent of women last four to seven years. Now, there’s the ten to twenty five percent of women for whom that’s different. And we don’t know if at year three, at year four or at year seven if you are going to be on your way out of these symptoms or are you going to be one of these ten to twenty five percent that is going to last longer. There is no way to really know that. We are trying to get some understanding. If you’ve had severe PMS, it seems to have some prediction on menopause being more severe. That’s one thing we seem to see a correlation with now. But unfortunately, we can’t really predict what your menopause is going to be like, let alone, can we predict how long it’s going to last. But we can work with the law of averages and try to give some reassurance. And most symptoms are temporary in most women. The problem is there’s the women that are not “most women” and the problem is that there are a few symptoms that tend to be progressive, like vaginal dryness, vaginal thinning, urinary incontinence, that set of symptoms tends to get worse with time because that tissue gets more consequences as it is deprived of estrogen for a longer period of time. But most other things, symptoms, not bone loss, not some of those things, but symptoms. Most of those are temporary in most women.