Menopause and andropause both carry brain fog along with them. Both of these states are age-related and have a lot to do with hormones, especially estrogen and testosterone. To set the record straight, let’s define both of these “pauses.”
Menopause:
Men-o-pause is when a woman’s menstrual cycles “pause.” Officially, it’s when a woman goes twelve months without a menstrual period. Menopause occurs in mid-life, around 40 to 50. In the US, the average age of menopause is 51.
Women will likely start “feeling” the effects of menopause well before the official diagnosis. Annoying symptoms like hot flashes, night sweats, and mood changes are common along with several other symptoms.
Generally speaking, menopause is caused by declining production of estrogen and progesterone, the two hormones that control menstrual periods. These two hormones and testosterone are produced in women’s ovaries in a cyclical rhythm.
Andropause (male menopause):
Andropause, unlike menopause, is less easy to pin down. Generally, it starts in mid-life, but it happens slowly, and its earmark is declining testosterone levels. Low energy levels, loss of libido, weight gain (man boobs), and brain fog are classic andropause symptoms, and there are more.
This “male menopause” is caused by lower production of testosterone with age and the increasing aromatization of testosterone into estrogen (which inhibits the production of testosterone).
This vicious cycle is the underpinning of andropause.
Estrogen, the master hormone:
Although it’s a little complicated, estrogen regulates testosterone in both men and women. This might come as a surprise to many, but here’s a brief and simplified explanation.
In women, when ovaries produce estrogen, testosterone is a by-product of that process. Estrogen (especially estradiol) is chemically very similar to testosterone. Thus, it is as if testosterone is a waste product of estrogen production in women. There does not appear to be a direct regulation of testosterone levels in healthy women.
In men, there is an inverse relationship between estrogen and testosterone. When men’s estrogen levels go down, this triggers the production of testosterone. Some of the testosterone is turned into estrogen (aromatization), bringing estrogen levels back up and shutting off the production of testosterone.
This “hormonal dance” goes on in men without stopping. Slowing down over the years, yes, but not completely stopping. In women, testosterone production stops when their ovaries stop making estrogen.
OVARIES:
In women, testosterone is made in their ovaries as a by-product of estrogen production.
For men, estrogen levels regulate the production of testosterone by the testes.
Brain Fog:
Brain fog is typically described as fuzzy thinking, being mentally slow or dull, or feeling like you’re in a daze.
This common condition is not itself a disease but rather a symptom with many possible causes, ranging from simple fatigue and lack of sleep to hormonal changes during and after menopause.
Since this post is about menopause, andropause, and estrogen’s role in brain fog, this will be the subject through the rest of this newsletter.
Fuzzy thinking is more common than we think:
Many types of mental functions can be a version of brain fog. Forgetfulness, short-term memory loss, slow thinking, and not being able to bring forth familiar names and descriptions. Sometimes, you feel detached from reality or like your mind is elsewhere.
Brain fog can also come and go with no apparent cause during menopause and andropause. It is no coincidence, however, that estrogen levels are unstable during these times, and so is testosterone.
So let’s look at these separately:
Estrogen:
Through menopause:
Although it’s difficult to separate depression from brain fog, they often go together. It has been shown that progressing through menopause from beginning to end, both depression and loss of mental acuity (brain fog) increase as estrogen production decreases.
Now, this is a correlation and does not mean that loss of estrogen is the cause of brain fog. It’s more complex than that.
Through andropause:
Ironically, estrogen levels in men increase during the time they decrease in women due to the vicious cycle described above. Generally, estrogen in men tends to increase in men, especially if they are overweight. Brain fog increases as estrogen increases in men. This is the opposite of what happens in women.
Men need estrogen to stay healthy, but too much can be destructive. Again, this is correlational, not causative, the hormonal interplay here is complex.
Testosterone:
During menopause:
As explained above, testosterone is a by-product of ovaries’ estrogen production; as estrogen levels decrease, so does testosterone. These two hormones work together.
One of the symptoms of low testosterone in women is a loss of the ability to concentrate.
During andropause:
In men, estrogen and testosterone are inversely related. As men age, and especially if they are overweight, testosterone levels drop. In fact, after their thirties men’s testosterone levels drop by a couple of percentage points every year.
Low testosterone in men causes many problems, and one of them clearly is brain fog.
Again, regarding testosterone, these are correlations, and these hormonal interactions are very complex, and it is difficult to establish causal relationships.
Discussions:
I do not give medical advice. My advice is to seek professional advice from experts in the field of endocrinology or whomever your personal healthcare provider recommends.
Having said that, if you suffer from brain fog and are otherwise healthy, you might benefit from hormonal treatments.
Get the best advice you can, and do not accept that this is normal and to be expected or that it’s just aging and it happens to everyone.
Take notice: In the past few years, hormonal augmentation has advanced significantly and is continuing to improve as knowledge grows.
Medical professionals:
I’ve been with my doctor for 23 years. I love her and consider her one of my life’s blessings. I am never critical of medical professionals. They work hard and have many obligations and rules to follow.
The rate of change in medical specialties is exponential, making it impossible for primary care physicians to keep up. Knowing where to refer you is the next best thing.
If you are suffering from brain fog to the point it is causing problems in your daily life, please see your doctor and ask for a referral. Chances are the odds of relief are in your favor.
Yes, there are other “change of life” problems that I will address in the future, but many of them will improve with the same treatments for brain fog.
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Especially for women: Don’t accept from friends and professionals alike that what you’re going through is normal and you just have to tough it out. There is a bell-shaped curve on the severity of menopause symptoms. You might be at the high end of misery while others are at the bottom.
Don’t take it, insist on help.
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Final note: I purposely did not discuss progesterone. This vital hormone deserves its own newsletter to do it justice.
OMY1
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