womens guide
Symptoms Overview
Menstruation Changes
Hot Flashes
Sleep Disturbances
Cognitive Symptoms
Vaginal Dryness
Urinary Incontinence
Treatment Overview
Hormone Therapy
Herbal Remedies


Headaches, Memory, & Depression

During perimenopause, many women report central nervous symptoms such as headaches, changes in memory and concentration, depression, mood swings, and anxiety.


There is a wide variety of headache types and associated causes such as allergies, stress, dental issues, and infection. Headaches are triggered in susceptible people by a variety of factors, including: certain foods (cheese, red wine), lack of sleep, too much sleep, stress, anxiety, fasting or skipping meals, bright lights, and changes in weather or barometric pressure.

Research shows that hormones also have a role in headaches. Before menopause, these hormonal headaches tend to exhibit themselves during menstrual periods and when taking hormonal oral contraceptives. During perimenopause, the erratic swings in estrogen and progesterone levels often trigger hormonal headaches in women who were already susceptible to begin with. Hormonal headaches typically cease when menopause is finally reached and hormone levels stabilize.

While most headaches can be addressed with simple over the counter pain medications, some headaches are considered serious and should be reported to your healthcare provider.

Symptoms of a “serious” headache include:

  • Severe pain that is unusual with respect to other headaches you’ve had (think worst ever)
  • Headaches that wake you up from sleep
  • Headaches that include stiff neck and high fever
  • Headaches with include confusion, dizziness, and/or weakness
  • A series of progressively worsening headaches

Serious headaches and migraines often require prescription medication. For hormonal headaches, occurrences can often be lessened and pain relieved by stabilizing your hormones levels with hormone replacement therapy. If you have migraine headaches however, there is a chance that estrogen therapy will make the headache worse. Consulting a professional is required to make a full diagnosis and treatment plan.

Memory & Concentration problems

Cognitive abilities such as memory and concentration change throughout life. Aging is often associated with a decline in mental abilities, and some of the most common complaints reported by women going through menopause are difficulty remembering and concentrating.

While there is no firm evidence that cognitive abilities decline directly due to natural menopause, scientist do know that hormones such as estrogen positively affect growth and sustenance of nerve cells in the hippocampus (memory center of the brain) and that decreased production during menopause may affect short term memory in some women.

These difficulties in memory and concentration often frighten women, who may mistakenly believe they are exhibiting the early signs of Alzheimer’s disease or other mental dementia, but that is rarely ever the case.

In addition to the role of hormones on memory, it is thought that typical menopausal symptoms such as night sweats and hot flashes may contribute indirectly to overall cognitive function by interfering with your normal sleep routine. A good night’s rest is essential in proper mental functioning, regardless of age.

At present point, the research is inconclusive as to the benefits or risks associated with using hormone replacement therapy to treat declining cognitive abilities.

Depression, Anxiety, and Mood Swings

Many women going through menopause report feelings of sadness, mood swings, anxiety, and discouragement. While this may be the case, current scientific research does not show direct link between menopause and true clinical depression, severe anxiety, or erratic behavior. Psychological problems are not caused by menopause.

Nevertheless, in women who are already susceptible to these problems, the abrupt change in hormonal levels and the accompanying physical symptoms can trigger these psychological problems. For example, while decreased estrogen production may not directly case irritability and moodiness, the sleep deprivation caused by night sweats can often result in fatigue, increased moodiness, and irritability.

Depressed moods during perimenopause are most frequently encountered by women who have a personal history of depression prior to menopause (including having PMS), who have a longer than normal perimenopause length, or have more severe menopause symptoms (e.g. hot flashes).

Additionally, women in perimenopause may be going through external stresses unique to midlife that may be unaccustomed to. These would include such things divorce, widowhood, childlessness, aging parents, loss of self-esteem, etc. All of these life cycle issues may trigger feelings of depression, independent of hormone levels.

If you are your loved ones are going through severe depression or anxiety, you may need to seek professional help.

Clinical depression. Symptoms include: loss of interest in normal activities, sadness, irritability, decreased sex drive. If you experience these for two week or longer, you may have clinical depression. While clinical depression is not caused by menopause, women you have had depression in the past are more vulnerable to recurrent depression during perimenopause.

Anxiety. Symptoms of panic attacks include shortness of breath, chest pain, dizziness, heart palpitations, and feelings of being out of control or crazy. These feelings may sometimes be triggered by hot flashes.

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